Intent Performance Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

INTENT PERFORMANCE PHYSICAL THERAPY

Practice address

118 E Avenida San Juan
San Clemente, CA 92672-3231

Phone

(949) 433-8160

NPI assigned

Feb 7, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Nathan Gordon Jeffries, DPT

Title

Owner

Phone

(949) 433-8160

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1902438898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E AVENIDA SAN JUAN",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723231",
            "telephone_number": "949-433-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E AVENIDA SAN JUAN",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723231",
            "telephone_number": "949-433-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENT PERFORMANCE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "JEFFRIES",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-433-8160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.intentpt.com",
            "affiliation": "N",
            "address_1": "118 E Avenida San Juan",
            "city": "San Clemente",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926723231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephenie Jo Ilagan, BCBA
• Ilene Blaisch
• Raymond J Imatani, MD
• Immersive Wellness Centers, LLC (Immersive Wellness Centers)
• Inchel Yeam
• International Awareness Integration Institute
• Homayon Iraninezhad, DO
• J.R. Johnson, M.D., Inc
• Yasmina Jabri, BCBA
• Jaesung Kim DMD Inc (I love my dentist)

• Physical Therapy Clinic/Center in San Clemente, CA
• Providers in San Clemente, 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 Feb 7, 2020; 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.