Impact Dance and Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

IMPACT DANCE AND PHYSICAL THERAPY PC

Practice address

7857 Convoy CT
San Diego, CA 92111-1221

Phone

(619) 666-2120

NPI assigned

Oct 7, 2026

Last updated

Oct 7, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Blair Tayloe, PT, DPT

Title

Clinic Owner

Phone

(619) 666-2120

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1791331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1861396137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7857 CONVOY CT STE 211",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111221",
            "telephone_number": "619-666-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7857 CONVOY CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111221",
            "telephone_number": "619-666-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT DANCE AND PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-07",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "TAYLOE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "BLAIR",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "619-666-2120",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Nicole Imhoff
• Gregory Phillip Imler, M.D.
• Katherine Laura Immerman, M.D.
• Kayla Imms
• Impact
• Impact Medical Associates California
• Impedimed Inc
• Chloe Christin Impellizeri
• Shannon Imper, LMFT
• Imperial Beach Community Clinic (Nestor Community Health Center)

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.