Individual provider Active NPI

Jennifer Reynolds Carr, DPT

  • Physical Therapist
  • Santa Monica, CA
National Provider Identifier
1801101266
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36908 Issued in CA
Practice address
1821 Wilshire Blvd
Suite 400
Santa Monica, CA 90403
Phone
(310) 828-2188
Fax
(310) 829-1379
NPI assigned
Aug 10, 2010
Last updated
Aug 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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 36908 CA Primary

Addresses

Primary practice location

1821 Wilshire Blvd
Suite 400
Santa Monica, CA 90403

Mailing address

1821 Wilshire Blvd
Suite 400
Santa Monica, CA 90403
Phone (310) 828-2188

Other names 1

  • Miss Jennifer Ann Reynolds Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101130000088 CA Practitioner - Physical Therapist in Private Practice 4385830603 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2730 Wilshire Blvd
Suite 105
Santa Monica, CA 90403-4724

5016 E Shomi St
Phoenix, AZ 85044-4115

9630 Braddock Dr
Culver City, CA 90232-2802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36908CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Physical Therapy and Wellness, PC Physical Therapist CurrentSince Oct 3, 2016 Accepting new patients
Origin Physical Therapy Ca Inc Physical Therapist CurrentSince Oct 8, 2024 Accepting new patients
Layfield & Associates Physical Therapy Inc Physical Therapist PastSince Apr 12, 2007 Accepting new patients

Locations

7188 Avenida Encinas
Ste 110
Carlsbad, CA 92011

11980 San Vicente Blvd
Ste 100
Los Angeles, CA 90049
Phone (310) 241-4885

2730 Wilshire Blvd
Ste 105
Santa Monica, CA 90403
Phone (310) 310-2931

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1801101266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD",
            "address_2": "SUITE 400",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-828-2188",
            "fax_number": "310-829-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD",
            "address_2": "SUITE 400",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-828-2188",
            "fax_number": "310-829-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "JENNIFER",
        "middle_name": "REYNOLDS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "REYNOLDS",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.