Cbad Enterprises, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT19837 Issued in CA

Legal business name

CBAD ENTERPRISES, INC

Practice address

6215 El Camino Real Ste 100
Elite Performance Institute
Carlsbad, CA 92009-1604

Phone

(760) 603-7900

Fax

(760) 603-7997

NPI assigned

Jan 8, 2008

Organization subpart

No

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

Authorized official

Name

Susan Lynne Croke, P.T.

Title

Physical Therapist

Phone

(760) 603-7900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Susan Croke Physical Therapy Services Doing business as

Locations

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1851576839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2588 EL CAMINO REAL",
            "address_2": "F249",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081211",
            "telephone_number": "760-603-7900",
            "fax_number": "760-603-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 EL CAMINO REAL STE 100",
            "address_2": "ELITE PERFORMANCE INSTITUTE",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920091604",
            "telephone_number": "760-603-7900",
            "fax_number": "760-603-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CBAD ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "CROKE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "760-603-7900",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT19837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1265480560",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT 19837",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan Croke Physical Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Center for Optimal Movement

• Physical Therapy Clinic/Center in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Physical Therapy Clinic/Center in California

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