Organization Active NPI

Red Bluff Physical Therapy Inc

  • Physical Therapist
  • Red Bluff, CA
National Provider Identifier
1902861602
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT14685 Issued in CA
Legal business name
RED BLUFF PHYSICAL THERAPY INC
Practice address
100 Jackson St
Red Bluff, CA 96080-3954
Phone
(530) 529-5777
Fax
(530) 529-5772
NPI assigned
Apr 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
James Montana, P.T.NPI 1114028305
Title
Owner
Phone
(530) 529-5777

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT14685 CA Primary

Addresses

Primary practice location

100 Jackson St
Red Bluff, CA 96080-3954

Mailing address

PO Box 496084
Redding, CA 96049-6084
Phone (530) 241-0473

Other identifiers 3

IdentifierTypeStateIssuer
ZZZ135352OtherBLUE SHIELD GROUP NUMBER
PT0146850MedicaidCA
P00052571OtherRAIL ROAD MEDICARE PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040719001612 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7113906405 Receives reassigned benefits from 2 practitioners
Practice locations: Red Bluff, CA; Redding, CA

National Provider Directory

National Provider Directory

Locations

100 Jackson St
Red Bluff, CA 96080
Phone (530) 241-1473

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1902861602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "530-241-0473",
            "fax_number": "530-241-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803954",
            "telephone_number": "530-529-5777",
            "fax_number": "530-529-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED BLUFF PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "MONTANA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-529-5777",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT14685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP NUMBER",
            "identifier": "ZZZ135352",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0146850",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE PIN",
            "identifier": "P00052571",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bluff, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.