NPIMap

Organization Active NPI

Shoreline Physical Therapy, Inc.

  • Orthopedic Physical Therapist
  • Huntington Beach, CA
National Provider Identifier
1760453229
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT25126 Issued in CA
Legal business name
SHORELINE PHYSICAL THERAPY, INC.
Practice address
9036 Adams Ave
Huntington Beach, CA 92646
Phone
(714) 963-3632
Fax
(714) 965-0682
NPI assigned
Jan 31, 2006
Last updated
Jul 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Authorized official

Name
Tim Murphy
Title
VP Operations
Phone
(818) 880-8605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X PT25126 CA Primary

Addresses

Primary practice location

9036 Adams Ave
Huntington Beach, CA 92646

Mailing address

26500 Agoura Rd Ste 102-587
Calabasas, CA 91302-1952
Phone (818) 880-8605

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000346 CA Part B Supplier - Clinic/Group Practice 7113814211 Receives reassigned benefits from 10 practitioners
Practice locations: Huntington Beach, CA

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

21501 Brookhurst St
Ste G
Huntington Beach, CA 92646
Phone (714) 963-3632

Practitioners & affiliated clinicians

Practitioners 12

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": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531267200000",
    "number": "1760453229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26500 AGOURA RD STE 102-587",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021952",
            "telephone_number": "818-880-8605",
            "fax_number": "818-579-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9036 ADAMS AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92646",
            "telephone_number": "714-963-3632",
            "fax_number": "714-965-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2018-07-11",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "818-880-8605"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT25126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.