NPIMap

Organization Active NPI

Elite Orthosport Performance Physical Therapy

  • Sports Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1942953724
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
Legal business name
ELITE ORTHOSPORT PERFORMANCE PHYSICAL THERAPY
Practice address
12121 Wilshire Blvd Ste 100
Los Angeles, CA 90025-1221
Phone
(310) 477-7774
NPI assigned
Feb 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Authorized official

Name
Heather Milligan, PTNPI 1144307067
Title
Owner/President
Phone
(310) 477-7774

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
Sports Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251S0007X Primary

Addresses

Primary practice location

12121 Wilshire Blvd Ste 100
Los Angeles, CA 90025-1221

Mailing address

12121 Wilshire Blvd Ste 100
Los Angeles, CA 90025-1221
Phone (310) 477-7774

Other practice location 1

12121 Wilshire Blvd Ste 101
Los Angeles, CA 90025-1123
Phone (310) 477-7774

Other names 1

  • Elite OrthoSport Performance Physical Therapy Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address email@eliteorthosport.com Direct Elite Orthosport Physical Therapy
Other URL 3104777773 Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Elite Orthosport Performance Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12121 Wilshire Blvd
Ste 101
Los Angeles, CA 90025
Phone (310) 477-7774

12121 Wilshire Blvd
Ste 100
Los Angeles, CA 90025
Phone (310) 477-4774

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1942953724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 WILSHIRE BLVD STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251221",
            "telephone_number": "310-477-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 WILSHIRE BLVD STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251221",
            "telephone_number": "310-477-7774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12121 Wilshire Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900251123",
            "country_code": "US",
            "telephone_number": "310-477-7774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE ORTHOSPORT PERFORMANCE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "MILLIGAN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "310-477-7774",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "email@eliteorthosport.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Elite Orthosport Physical Therapy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "12121 Wilshire Blvd Ste 100",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900251221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "3104777773",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "All",
            "address_1": "12121 Wilshire Blvd Ste 100",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900251221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Elite OrthoSport Performance Physical Therapy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Elite OrthoSport Performance Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.