NPIMap

Organization Active NPI

Sacramento Spine & Physical Therapy Inc.

  • Orthopedic Physical Therapist
  • Roseville, CA
National Provider Identifier
1851469845
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
SACRAMENTO SPINE & PHYSICAL THERAPY INC.
Practice address
1650 Lead Hill Blvd
300
Roseville, CA 95661-3061
Phone
(916) 677-1210
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Travis R Smith
Title
Owner
Phone
(916) 932-1210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

1650 Lead Hill Blvd
300
Roseville, CA 95661-3061

Mailing address

1650 Lead Hill Blvd
300
Roseville, CA 95661-3061
Phone (916) 677-1210

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ18195ZOtherCAMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000858 CA Part B Supplier - Clinic/Group Practice 7416861901 Receives reassigned benefits from 6 practitioners
Practice locations: Roseville, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sacramento Spine and 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

2575 E Bidwell St
Folsom, CA 95630
Phone (916) 817-2210

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1851469845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LEAD HILL BLVD",
            "address_2": "300",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613061",
            "telephone_number": "916-677-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LEAD HILL BLVD",
            "address_2": "300",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613061",
            "telephone_number": "916-677-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRAMENTO SPINE & PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-932-1210"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ18195Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.