Individual provider Active NPI

Jimmy Lin, DPT, OCS, CSCS

  • Orthopedic Physical Therapist
  • Arcadia, CA
National Provider Identifier
1780006478
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
33405 Issued in CA
Practice address
865 W Foothill Blvd
Arcadia, CA 91006-2035
Phone
(626) 422-2863
NPI assigned
Jan 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 34405 CA
Orthopedic Physical Therapist 2251X0800X 33405 CA Primary

Addresses

Primary practice location

865 W Foothill Blvd
Arcadia, CA 91006-2035

Mailing address

865 W Foothill Blvd
Arcadia, CA 91006-2035
Phone (626) 422-2863

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
33405CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lin Fitness Company, LLC. Orthopedic Current Accepting new patients
Orthosport Physical Therapy CurrentSince Jan 10, 2021 Accepting new patients

Locations

5722 Kalanianaole Hwy
Honolulu, HI 96821
Phone (808) 373-1114

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": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1780006478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 W FOOTHILL BLVD",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910062035",
            "telephone_number": "626-422-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 W FOOTHILL BLVD",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910062035",
            "telephone_number": "626-422-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "JIMMY",
        "credential": "DPT, OCS, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-14",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "34405",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "33405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.