NPIMap

Organization Active NPI

Ivey Physical Therapy a Professional Corporation

Doing business as Sanderson Ivey Physical Therapy

  • Physical Therapy Clinic/Center
  • Grass Valley, CA
National Provider Identifier
1720117104
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT20829 Issued in CA
Legal business name
IVEY PHYSICAL THERAPY A PROFESSIONAL CORPORATION
Doing business as
Sanderson Ivey Physical Therapy
Practice address
10565 Brunswick Rd
Suite 4
Grass Valley, CA 95945-9053
Phone
(530) 273-4152
Fax
(530) 273-4153
NPI assigned
Mar 3, 2007
Last updated
Jul 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kevin Dale IveyNPI 1962596908
Title
President
Phone
(530) 273-4152

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT20829 CA Primary

Addresses

Primary practice location

10565 Brunswick Rd
Suite 4
Grass Valley, CA 95945-9053

Mailing address

10565 Brunswick Rd
Suite 4
Grass Valley, CA 95945-9053
Phone (530) 273-4152

Other names 1

  • Sanderson Ivey Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1720117104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10565 BRUNSWICK RD",
            "address_2": "SUITE 4",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459053",
            "telephone_number": "530-273-4152",
            "fax_number": "530-273-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10565 BRUNSWICK RD",
            "address_2": "SUITE 4",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459053",
            "telephone_number": "530-273-4152",
            "fax_number": "530-273-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVEY PHYSICAL THERAPY A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-03",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "IVEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-273-4152"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT20829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanderson Ivey Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanderson Ivey Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.