Personal Edge Physical Therapy, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT 34053 Issued in CA

Legal business name

PERSONAL EDGE PHYSICAL THERAPY, INC.

Practice address

7080 Donlon Way
#108
Dublin, CA 94568-2787

Phone

(925) 556-4310

Fax

(925) 556-0375

NPI assigned

Nov 6, 2007

Organization subpart

No

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

Authorized official

Name

Gina Mary Villa

Title

Admin. Direcor / Secretary

Phone

(925) 556-4310

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Katherine Kipouras, P.T.

  • Physical Therapist
  • Salem, NH
  • NPI 1578658324
  NPD (past)

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1861672958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7080 DONLON WAY",
            "address_2": "#108",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682787",
            "telephone_number": "925-556-4310",
            "fax_number": "925-556-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 DONLON WAY",
            "address_2": "#108",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682787",
            "telephone_number": "925-556-4310",
            "fax_number": "925-556-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL EDGE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "ADMIN. DIRECOR / SECRETARY",
        "authorized_official_telephone_number": "925-556-4310"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT 23848",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT 34053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ23426Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID",
            "identifier": "ZZZ64073Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mario Perez, DPT
• Michelle Perez
• Rebecca Reyna Perez
• Trier Perry
• Persimmon Dental Care
• Personal Edge PT, Inc.
• Katherine Nicole Pesochinskiy
• Rebecca Pessagno
• Geera Peters, MD
• Rebekah Peterson

• Physical Therapy Clinic/Center in Dublin, CA
• Providers in Dublin, 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 Jun 18, 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.