NPIMap

Organization Active NPI

Ron L Kopitzke PT, DPT Ocs

Doing business as Sierra Orthopaedic & Athletic Rehabilitation

  • Specialist
  • Placerville, CA
National Provider Identifier
1821008236
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT106430 Issued in CA
Legal business name
RON L KOPITZKE PT, DPT OCS
Doing business as
Sierra Orthopaedic & Athletic Rehabilitation
Practice address
4300 Golden Center Dr
Suite B
Placerville, CA 95667-6278
Phone
(530) 344-2045
Fax
(530) 642-0794
NPI assigned
Aug 8, 2006
Last updated
Jul 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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

Authorized official

Name
Mr. Ron L Kopitzke, PT DPT OCSNPI 1972546752
Title
Owner
Phone
(530) 344-2045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT106430 CA Primary

Addresses

Primary practice location

4300 Golden Center Dr
Suite B
Placerville, CA 95667-6278

Mailing address

4300 Golden Center Dr Ste B
Placerville, CA 95667
Phone (530) 344-2045

Other identifiers 1

IdentifierTypeStateIssuer
OPT106430OtherPTAN

Other names 1

  • Sierra Orthopaedic & Athletic Rehabilitation Doing business as

National Provider Directory

National Provider Directory

Locations

4300 Golden Center Dr
Ste B
Placerville, CA 95667
Phone (530) 344-2045

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1821008236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 GOLDEN CENTER DR STE B",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "95667",
            "telephone_number": "530-344-2045",
            "fax_number": "530-642-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 GOLDEN CENTER DR",
            "address_2": "SUITE B",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676278",
            "telephone_number": "530-344-2045",
            "fax_number": "530-642-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RON L KOPITZKE PT, DPT OCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "KOPITZKE",
        "authorized_official_first_name": "RON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-344-2045",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT DPT OCS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT106430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "OPT106430",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sierra Orthopaedic & Athletic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.