Active NPI
Lincoln Physical and Occupational Therapy, Inc
- Orthopedic Physical Therapist
- Lincoln, CA
National Provider Identifier
1912066705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT 14005
- Legal business name
- LINCOLN PHYSICAL AND OCCUPATIONAL THERAPY, INC
- Practice address
- 150 Gateway Dr Ste a
Lincoln, CA 95648-3316 - Phone
- (916) 434-9572
- Fax
- (916) 434-9063
- NPI assigned
- Dec 7, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Dewitt, OT
- Title
- Ceo
- Phone
- (916) 434-9572
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT 14005 | CA | Primary |
Addresses
Primary practice location
150 Gateway Dr Ste a
Lincoln, CA 95648-3316
Mailing address
150 Gateway Dr Ste a
Lincoln, CA 95648-3316
Phone (916) 434-9572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071026000164 | CA | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 5799872537 |
Receives reassigned benefits from 4 practitioners Practice locations: Lincoln, CA |
National Provider Directory
National Provider DirectoryLocations
150 Gateway Dr
Ste A
Lincoln, CA 95648
Phone (916) 434-9572
1530 3rd St
Ste 211
Lincoln, CA 95648
Phone (916) 434-9572
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapy Assistant
- Lincoln, CA
- NPI 1255410767
CA
-
- Physical Medicine & Rehabilitation Physician
- Lincoln, CA
- NPI 1639039985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165449600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1725926400000",
"number": "1912066705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 GATEWAY DR STE A",
"city": "LINCOLN",
"state": "CA",
"postal_code": "956483316",
"telephone_number": "916-434-9572",
"fax_number": "916-434-9063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 GATEWAY DR STE A",
"city": "LINCOLN",
"state": "CA",
"postal_code": "956483316",
"telephone_number": "916-434-9572",
"fax_number": "916-434-9063"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LINCOLN PHYSICAL AND OCCUPATIONAL THERAPY, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-07",
"last_updated": "2024-09-10",
"certification_date": "2024-09-10",
"status": "A",
"authorized_official_last_name": "DEWITT",
"authorized_official_first_name": "MARY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "916-434-9572",
"authorized_official_credential": "OT"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "PT 14005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lincoln, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.