Premium Physical Therapy Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PREMIUM PHYSICAL THERAPY INC

Practice address

2021 Herndon Ave
Ste. 102
Clovis, CA 93611-6101

Phone

(559) 321-8405

Fax

(559) 900-7952

NPI assigned

Jul 30, 2015

Organization subpart

No

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

Authorized official

Name

Russell Shawn Biggers, DPTNPI 1669511028

Title

Owner

Phone

(559) 321-8405

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Russell S Biggers, DPT

  • Physical Therapist
  • Clovis, CA
  • NPI 1669511028
  Medicare reassignment Authorized official
• Brontae Noel Gomes

  • Physical Therapy Assistant
  • Clovis, CA
  • NPI 1457093601
  NPD

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1801272992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7471 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202457",
            "telephone_number": "559-436-6228",
            "fax_number": "559-436-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 HERNDON AVE",
            "address_2": "STE. 102",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116101",
            "telephone_number": "559-321-8405",
            "fax_number": "559-900-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-30",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "BIGGERS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-321-8405",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "261QP2000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Clovis, CA
• Providers in Clovis, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.