NPIMap

Organization Active NPI

Blue Skies Physical Therapy

  • Sports Physical Therapist
  • Lake Elsinore, CA
National Provider Identifier
1750975140
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
Legal business name
BLUE SKIES PHYSICAL THERAPY
Practice address
20701 Cereal St
Skydive Elsinore, Team Room 8
Lake Elsinore, CA 92530-9253
Phone
(702) 904-0178
NPI assigned
Feb 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Authorized official

Name
Nancy N Grieger, PT, EMTNPI 1003956798
Title
Owner, Physical Therapist, Emt-B
Phone
(702) 904-0178

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 146N00000X
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X Primary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X

Addresses

Primary practice location

20701 Cereal St
Skydive Elsinore, Team Room 8
Lake Elsinore, CA 92530-9253

Mailing address

24375 Jackson Ave Apt N308
Murrieta, CA 92562-1916
Phone (702) 904-0178

Other names 1

  • Blue Skies Physical Therapy Former legal business name

National Provider Directory

National Provider Directory

Locations

20701 Cereal St
Rm 8
Lake Elsinore, CA 92530
Phone (702) 904-0178

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1750975140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24375 JACKSON AVE APT N308",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925621916",
            "telephone_number": "702-904-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20701 CEREAL ST",
            "address_2": "SKYDIVE ELSINORE, TEAM ROOM 8",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925309253",
            "telephone_number": "702-904-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKIES PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "GRIEGER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST, EMT-B",
        "authorized_official_telephone_number": "702-904-0178",
        "authorized_official_credential": "PT, EMT"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Basic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Skies Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.