NPIMap

Organization Active NPI

Stithem & Johnson Physical Therapy Inc.

Doing business as Orthopaedic & Sports Physical Therapy

  • Physical Therapy Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1831386838
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
STITHEM & JOHNSON PHYSICAL THERAPY INC.
Doing business as
Orthopaedic & Sports Physical Therapy
Practice address
6574 Oakmont Dr
Ste a
Santa Rosa, CA 95409-5958
Phone
(707) 539-5256
Fax
(707) 539-7914
NPI assigned
Oct 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Authorized official

Name
Ms. Megan Sierra Newhall, BA
Title
Clinic Administrator
Phone
(707) 571-7615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

6574 Oakmont Dr
Ste a
Santa Rosa, CA 95409-5958

Mailing address

795 Farmers LN
Ste 10
Santa Rosa, CA 95405-6718
Phone (707) 571-7615

Other identifiers 1

IdentifierTypeStateIssuer
DA6103OtherCARAILROAD MEDICARE PTAN

Other names 1

  • Orthopaedic & Sports Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000745 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7214836600 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Santa Rosa, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Orthopaedic and Sports Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6574 Oakmont Dr
Ste A
Santa Rosa, CA 95409
Phone (707) 539-5256

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1831386838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 FARMERS LN",
            "address_2": "STE 10",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056718",
            "telephone_number": "707-571-7615",
            "fax_number": "707-571-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6574 OAKMONT DR",
            "address_2": "STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954095958",
            "telephone_number": "707-539-5256",
            "fax_number": "707-539-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STITHEM & JOHNSON PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "NEWHALL",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "SIERRA",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "707-571-7615",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DA6103",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopaedic & Sports Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.