Individual provider Active NPI

Julie Watkins, DPT

  • Physical Therapist
  • Oakland, CA
National Provider Identifier
1760955850
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
296012 Issued in CA
Practice address
4341 Piedmont Ave Ste 201
Oakland, CA 94611-4792
Phone
(510) 547-1630
Fax
(510) 923-1944
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 296012 CA Primary

Addresses

Primary practice location

4341 Piedmont Ave Ste 201
Oakland, CA 94611-4792

Mailing address

473 34TH St
Oakland, CA 94609-2815
Phone (510) 339-2116

Other practice location 1

473 34th St
Oakland, CA 94609-2815
Phone (510) 339-2116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
296012CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports & Orthopedic Leaders Physical Therapy, Inc Physical Therapist PastSince Oct 1, 2009 Accepting new patients
Simon Gibson Physical Therapist PastSince Jan 24, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1760955850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 34TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092815",
            "telephone_number": "510-339-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 PIEDMONT AVE STE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114792",
            "telephone_number": "510-547-1630",
            "fax_number": "510-923-1944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "473 34th St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946092815",
            "country_code": "US",
            "telephone_number": "510-339-2116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "JULIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.