Individual provider Active NPI

Larry Taylor, P.T.

  • Physical Therapist
  • Orange, CA
National Provider Identifier
1902915010
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6776 Issued in CA
Practice address
1045 N Tustin St
Orange, CA 92867-5904
Phone
(714) 288-8303
Fax
(714) 744-8153
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6776 CA Primary

Addresses

Primary practice location

1045 N Tustin St
Orange, CA 92867-5904

Mailing address

4230 Park Newport
Newport Beach, CA 92660-6015
Phone (949) 813-1699

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140703001587 CA Practitioner - Physical Therapist in Private Practice 2365667474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2116 E Orangeburg Ave
Suite B
Modesto, CA 95355-3370
Phone (209) 529-1709

2116 E Orangeburg B
Modesto, CA 95355-3370

450 Glass Lane C
Modesto, CA 95356-9287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic & Industrial Rehabilitatn Physical Therapy Inc a Prof Corp Physical Therapist CurrentSince May 12, 2014 Accepting new patients

Locations

1701 Coffee Rd
Ste 2
Modesto, CA 95355
Phone (209) 529-1709

2116 E Orangeburg Ave
Ste B
Modesto, CA 95355
Phone (209) 529-1709

450 Glass Ln
Ste C
Modesto, CA 95356

Organizations & group practices 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902915010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 PARK NEWPORT",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606015",
            "telephone_number": "949-813-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 N TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675904",
            "telephone_number": "714-288-8303",
            "fax_number": "714-744-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "LARRY",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "6776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.