On Track Physical Therapy and Performance, P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

29705 Issued in CA

Legal business name

ON TRACK PHYSICAL THERAPY AND PERFORMANCE, P.C.

Practice address

220 Country Club Gate Ctr
#11
Pacific Grove, CA 93950-5014

Phone

(831) 917-9886

NPI assigned

Aug 9, 2016

Last updated

Nov 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Blake Phillips RussellNPI 1316472616

Title

Owner

Phone

(831) 917-9886

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Blake Phillips Russell, MPT

  • Physical Therapist
  • Pacific Grove, CA
  • NPI 1316472616
  Authorized official Same address or phone
• Jane Ann Gingerich, L,C.S.W.

  • Clinical Social Worker
  • Pacific Grove, CA
  • NPI 1174680763
  NPD (past)

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606003200000",
    "number": "1811441629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 GRANITE ST",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939503219",
            "telephone_number": "831-917-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 COUNTRY CLUB GATE CTR",
            "address_2": "#11",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939505014",
            "telephone_number": "831-917-9886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON TRACK PHYSICAL THERAPY AND PERFORMANCE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "PHILLIPS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-917-9886"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barrie Elizabeth O'Brien, MFT
• Sean O'Sullivan
• Dale Gene Obrien, MD
• Eric Ochoa, MA, LMFT
• Cassandra Ohlsen, MD
• One Door Psychology, Inc
• Open Heart Therapy
• P.G.H.C.C., Inc (Pacific Grove Convalescent Hospital)
• Pacific Grove Acupuncture
• Pacific Grove Acupuncture, Inc.

• Physical Therapist in Pacific Grove, CA
• Providers in Pacific Grove, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2020; 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.