Individual provider Active NPI

Carl Dean Sebern

  • Physical Therapist
  • Fallbrook, CA
National Provider Identifier
1912395146
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12095 Issued in CA
Practice address
1023 Camino Alisos
Fallbrook, CA 92028-3763
Phone
(949) 300-4432
Fax
(760) 731-2232
NPI assigned
Dec 22, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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 PT12095 CA Primary

Addresses

Primary practice location

1023 Camino Alisos
Fallbrook, CA 92028-3763

Mailing address

1023 Camino Alisos
Fallbrook, CA 92028-3763
Phone (760) 731-2229

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT12095CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1912395146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 CAMINO ALISOS",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283763",
            "telephone_number": "760-731-2229",
            "fax_number": "760-731-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 CAMINO ALISOS",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283763",
            "telephone_number": "949-300-4432",
            "fax_number": "760-731-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBERN",
        "first_name": "CARL",
        "middle_name": "DEAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallbrook, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.