NPIMap

Organization Active NPI

Golden Bear Physical Therapy

  • Physical Therapy Assistant
  • Modesto, CA
National Provider Identifier
1841669710
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT11025 Issued in CA
Legal business name
GOLDEN BEAR PHYSICAL THERAPY
Practice address
4318 Spyres Way
Modesto, CA 95356-9259
Phone
(209) 576-0888
Fax
(209) 576-0913
NPI assigned
Sep 21, 2015
Last updated
Sep 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Authorized official

Name
Mr. Nicolas King, PTA
Title
Physical Therapist Assistant
Phone
(209) 576-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT11025 CA Primary

Addresses

Primary practice location

4318 Spyres Way
Modesto, CA 95356-9259

Mailing address

4318 Spyres Way
Modesto, CA 95356-9259
Phone (209) 576-0888

National Provider Directory

National Provider Directory
Tax ID family
Golden Bear PT2 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.

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1841669710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569259",
            "telephone_number": "209-576-0888",
            "fax_number": "209-576-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569259",
            "telephone_number": "209-576-0888",
            "fax_number": "209-576-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN BEAR PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "NICOLAS",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST ASSISTANT",
        "authorized_official_telephone_number": "209-576-0888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT11025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.