Sport & Spine Therapy of Marin Inc

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Legal business name

SPORT & SPINE THERAPY OF MARIN INC

Practice address

719 Southpoint Blvd
Suite a
Petaluma, CA 94954-1495

Phone

(707) 981-8062

Fax

(707) 981-8684

NPI assigned

Mar 2, 2016

Last updated

Oct 8, 2020By 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

Steven Thompson

Title

Owner/Ceo

Phone

(415) 898-1311

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Sport & Spine Therapy of Marin Inc

  • Orthopedic Physical Therapist
  • San Anselmo, CA
  • NPI 1154388577

  O20060710000148

  Same enrollment
• Sport & Spine Therapy of Marin Inc

  • Orthopedic Physical Therapist
  • Novato, CA
  • NPI 1174578199

  O20060710000148

  Same enrollment

Locations

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1861852964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949480950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 SOUTHPOINT BLVD",
            "address_2": "SUITE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541495",
            "telephone_number": "707-981-8062",
            "fax_number": "707-981-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT & SPINE THERAPY OF MARIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "415-898-1311"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kathryn Spengler
• Lewis Spengler
• Riley Spindler
• Samantha Sidney Spinner, PA-C
• Hilary Spolini
• Elizabeth Spranger
• SRM Alliance Hospital Services (Petaluma Valley Hospital)
• St Jude Hospital Yorba Linda (St Joseph Heritage Healthcare)
• St Jude Hospital Yorba Linda (St Joseph Heritage Healthcare)
• St. Joseph Home Care Network (Providence Hospice Sonoma County)

• Orthopedic Physical Therapist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.