Organization Active NPI

Cascade Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Redding, CA
National Provider Identifier
1942664438
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT26399 Issued in CA
Legal business name
CASCADE PHYSICAL THERAPY INC.
Practice address
1007 Dana Dr
Suite E
Redding, CA 96003-4036
Phone
(530) 222-5188
Fax
(530) 222-5167
NPI assigned
Apr 11, 2016
Last updated
Apr 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Authorized official

Name
Mr. Erick Kimble GossNPI 1487602942
Title
Owner/DPT
Phone
(530) 222-5188

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 Therapy Clinic/Center 261QP2000X PT26399 CA Primary

Addresses

Primary practice location

1007 Dana Dr
Suite E
Redding, CA 96003-4036

Mailing address

1007 Dana Dr
Suite E
Redding, CA 96003-4036
Phone (530) 222-5188

Other identifiers 1

IdentifierTypeStateIssuer
PT0263990MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160601001990 CA Part B Supplier - Clinic/Group Practice 7810287992 Receives reassigned benefits from 1 practitioner
Practice locations: Redding, CA

National Provider Directory

National Provider Directory

Locations

2123 Eureka Way
Redding, CA 96001
Phone (530) 243-9022

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460678400000",
    "number": "1942664438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 DANA DR",
            "address_2": "SUITE E",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034036",
            "telephone_number": "530-222-5188",
            "fax_number": "530-222-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 DANA DR",
            "address_2": "SUITE E",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034036",
            "telephone_number": "530-222-5188",
            "fax_number": "530-222-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-15",
        "status": "A",
        "authorized_official_last_name": "GOSS",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "KIMBLE",
        "authorized_official_title_or_position": "OWNER/DPT",
        "authorized_official_telephone_number": "530-222-5188",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT26399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0263990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.