Athletic Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ATHLETIC PHYSICAL THERAPY

Practice address

1464 Madera Rd
Suite G
Simi Valley, CA 93065-3077

Phone

(805) 306-1622

NPI assigned

Aug 12, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Clark, DPT

Title

President

Phone

(818) 340-2002

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Athletic Physical Therapy

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1295967057

  O20041202000150

  Same enrollment
• Athletic Physical Therapy

  • Physical Therapist
  • Encino, CA
  • NPI 1467684225

  O20041202000150

  Same enrollment
• Athletic Physical Therapy

  • Physical Therapist
  • Thousand Oaks, CA
  • NPI 1851523617

  O20041202000150

  Same enrollment
• Athletic Physical Therapy Inc

  • Physical Therapist
  • Westlake Village, CA
  • NPI 1114042165

  O20041202000150

  Same enrollment
• Athletic Physical Therapy, Inc

  • Physical Therapist
  • Oxnard, CA
  • NPI 1487966719

  O20041202000150

  Same enrollment

Locations

Practitioners 3

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

• Andrew Magpali, D.P.T

  • Physical Therapist
  • Simi Valley, CA
  • NPI 1194038919
  NPD (past)
• Leeann Mallari

  • Physical Therapy Assistant
  • Simi Valley, CA
  • NPI 1720654866
  NPD (past)
• Sean Edward Wronka, PHYSICAL THERAPIST

  • Orthopedic Physical Therapist
  • Simi Valley, CA
  • NPI 1093463788
  NPD (past)

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250035200000",
    "number": "1770715534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30877 THOUSAND OAKS BLVD",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624039",
            "telephone_number": "818-879-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1464 MADERA RD",
            "address_2": "SUITE G",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653077",
            "telephone_number": "805-306-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-340-2002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.