NPIMap

Organization Active NPI

Sacramento Spine & Physical Therapy Inc.

  • Physical Therapist
  • Folsom, CA
National Provider Identifier
1740399690
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SACRAMENTO SPINE & PHYSICAL THERAPY INC.
Practice address
700 Oak Avenue Pkwy Ste B
Folsom, CA 95630-6871
Phone
(916) 932-1210
NPI assigned
Aug 30, 2006
Last updated
Nov 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Travis R Smith
Title
Owner
Phone
(916) 932-1210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

700 Oak Avenue Pkwy Ste B
Folsom, CA 95630-6871

Mailing address

PO Box 2710
Granite Bay, CA 95746-2710
Phone (916) 932-1210

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ32774ZOtherCAMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000278 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7416861901 Receives reassigned benefits from 5 practitioners
Practice locations: Folsom, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sacramento Spine and Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

700 Oak Avenue Pkwy
Folsom, CA 95630

700 Oak Avenue Pkwy
Ste B
Folsom, CA 95630
Phone (916) 932-1210

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1740399690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2710",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957462710",
            "telephone_number": "916-932-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OAK AVENUE PKWY STE B",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306871",
            "telephone_number": "916-932-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRAMENTO SPINE & PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-932-1210"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ32774Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.