Individual provider Active NPI

Patrick Williams, P.T.

  • Physical Therapist
  • Capitola, CA
National Provider Identifier
1831119650
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25885 Issued in CA
Practice address
824 Bay Ave
60
Capitola, CA 95010-2104
Phone
(831) 475-0192
Fax
(831) 475-1303
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 25885 CA Primary

Addresses

Primary practice location

824 Bay Ave
60
Capitola, CA 95010-2104

Mailing address

334 Riverview Ave
Capitola, CA 95010-3235

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
25885CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Rehabilitation, Inc. Past Accepting new patients
Matrix Rehabilitation, Inc. Past Accepting new patients
Performance Physical Therapy and Sports Conditioning, Inc Physical Therapist PastSince Feb 24, 2013 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831119650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 RIVERVIEW AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950103235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 BAY AVE",
            "address_2": "60",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102104",
            "telephone_number": "831-475-0192",
            "fax_number": "831-475-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PATRICK",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "25885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitola, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.