Organization Active NPI

Atp Physical Therapy PC

  • Physical Therapist
  • South Pasadena, CA
National Provider Identifier
1730197948
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ATP PHYSICAL THERAPY PC
Practice address
1942 Huntington Dr
South Pasadena, CA 91030
Phone
(626) 403-6545
Fax
(626) 441-7660
NPI assigned
Aug 3, 2006
Last updated
Aug 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Authorized official

Name
Christopher Mark Mallett, DPTNPI 1942218169
Title
President/Owner
Phone
(626) 403-6545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1942 Huntington Dr
South Pasadena, CA 91030

Mailing address

1942 Huntington Dr
South Pasadena, CA 91030-4959
Phone (626) 403-6545

Other identifiers 1

IdentifierTypeStateIssuer
W19540OtherCAGROUP ID FOR ATP PHYSICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060202000268 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9436163151 Receives reassigned benefits from 1 practitioner
Practice locations: South Pasadena, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1730197948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 HUNTINGTON DR",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304959",
            "telephone_number": "626-403-6545",
            "fax_number": "626-441-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 HUNTINGTON DR",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "91030",
            "telephone_number": "626-403-6545",
            "fax_number": "626-441-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATP PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "MALLETT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "626-403-6545",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ID FOR ATP PHYSICAL",
            "identifier": "W19540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.