NPIMap

Organization Active NPI

Central Coast Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Paso Robles, CA
National Provider Identifier
1740424910
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT17156 Issued in CA
Legal business name
CENTRAL COAST PHYSICAL THERAPY, INC.
Practice address
1421 Riverside Ave
Paso Robles, CA 93446-1730
Phone
(805) 239-1202
Fax
(805) 239-1222
NPI assigned
Apr 30, 2009
Last updated
Aug 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Lee Haskin, DPTNPI 1548201023
Title
Owner
Phone
(805) 239-1202

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 Therapy Clinic/Center 261QP2000X PT17156 CA Primary

Addresses

Primary practice location

1421 Riverside Ave
Paso Robles, CA 93446-1730

Mailing address

1421 Riverside Ave
Paso Robles, CA 93446-1730
Phone (805) 239-1202

Other practice location 1

3218 El Camino Real
Atascadero, CA 93422-2500
Phone (805) 462-1110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120305000170 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1052464625 Receives reassigned benefits from 6 practitioners
Practice locations: Atascadero, CA; Paso Robles, CA

National Provider Directory

National Provider Directory
Tax ID family
Central Coast PT Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

3218 El Camino Real
Atascadero, CA 93422
Phone (805) 462-1110

7380 Morro Rd
Atascadero, CA 93422
Phone (805) 462-1110

1421 Riverside Ave
Paso Robles, CA 93446
Phone (805) 239-1202

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 8

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": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1740424910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 RIVERSIDE AVE",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934461730",
            "telephone_number": "805-239-1202",
            "fax_number": "805-239-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 RIVERSIDE AVE",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934461730",
            "telephone_number": "805-239-1202",
            "fax_number": "805-239-1222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3218 El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Atascadero",
            "state": "CA",
            "postal_code": "934222500",
            "country_code": "US",
            "telephone_number": "805-462-1110",
            "fax_number": "805-462-0660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL COAST PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2021-08-17",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "HASKIN",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-239-1202",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT17156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paso Robles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.