NPIMap

Organization Active NPI

South Pacific Physical Therapy Inc

  • Physical Therapist
  • Sherman Oaks, CA
National Provider Identifier
1891145108
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT36911 Issued in CA
Legal business name
SOUTH PACIFIC PHYSICAL THERAPY INC
Practice address
4940 Van Nuys Blvd
#301
Sherman Oaks, CA 91403-1700
Phone
(818) 907-0952
NPI assigned
Jun 17, 2016
Last updated
Dec 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Authorized official

Name
Doreen Akry, DPTNPI 1811204662
Title
Owner/Physical Therapist
Phone
(818) 907-0952

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT36911 CA Primary

Addresses

Primary practice location

4940 Van Nuys Blvd
#301
Sherman Oaks, CA 91403-1700

Mailing address

16161 Ventura Blvd
# C564
Encino, CA 91436-2522
Phone (818) 907-0952

Other names 1

  • C/O Doreen Akry Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161121002130 CA Part B Supplier - Clinic/Group Practice 8729367412 Receives reassigned benefits from 10 practitioners
Practice locations: Sherman Oaks, CA

National Provider Directory

National Provider Directory

Locations

16161 Ventura Blvd
#C564
Encino, CA 91436

4924 Balboa Blvd
Encino, CA 91316
Phone (805) 479-8706

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1891145108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16161 VENTURA BLVD",
            "address_2": "# C564",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362522",
            "telephone_number": "818-907-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 VAN NUYS BLVD",
            "address_2": "#301",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031700",
            "telephone_number": "818-907-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PACIFIC PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "AKRY",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "818-907-0952",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT36911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C/O Doreen Akry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.