Individual provider Active NPI

Gary W Lawrence, PT

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1902889785
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12300 Issued in CA
Practice address
2039 Forest Ave
Ste 104
San Jose, CA 95128-4817
Phone
(408) 279-8501
Fax
(408) 279-8504
NPI assigned
Nov 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT12300 CA Primary

Addresses

Primary practice location

2039 Forest Ave
Ste 104
San Jose, CA 95128-4817

Mailing address

246 Sobrante Way
Sunnyvale, CA 94086-4807
Phone (408) 733-3670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT12300CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard P Carr Physical Therapy Inc Physical Therapist Past Accepting new patients
Richard P. Carr Physical Therapy Inc Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1902889785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 SOBRANTE WAY",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940864807",
            "telephone_number": "408-733-3670",
            "fax_number": "408-245-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 FOREST AVE",
            "address_2": "STE 104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284817",
            "telephone_number": "408-279-8501",
            "fax_number": "408-279-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "GARY",
        "middle_name": "W",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.