NPIMap

Organization Active NPI

Spirit Winds Physical Therapy, Inc.

  • Physical Therapist
  • San Luis Obispo, CA
National Provider Identifier
1942969258
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPIRIT WINDS PHYSICAL THERAPY, INC.
Practice address
1257 Laurel LN
San Luis Obispo, CA 93401-5808
Phone
(805) 543-5100
Fax
(805) 543-5106
NPI assigned
Dec 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Miss Mickey Manrriquez
Title
Office Manager
Phone
(805) 543-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1257 Laurel LN
San Luis Obispo, CA 93401-5808

Mailing address

1257 Laurel LN
San Luis Obispo, CA 93401-5808
Phone (805) 543-5100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@spiritwindstherapy.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220208002144 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315330750 Receives reassigned benefits from 7 practitioners
Practice locations: San Luis Obispo, CA

National Provider Directory

National Provider Directory

Locations

1257 Laurel Ln
San Luis Obispo, CA 93401
Phone (805) 543-5100

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1942969258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 LAUREL LN",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015808",
            "telephone_number": "805-543-5100",
            "fax_number": "805-543-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 LAUREL LN",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015808",
            "telephone_number": "805-543-5100",
            "fax_number": "805-543-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT WINDS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-14",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "MANRRIQUEZ",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "805-543-5100",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@spiritwindstherapy.com",
            "affiliation": "N",
            "endpointDescription": "practice email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1257 Laurel Ln",
            "city": "San Luis Obispo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "934015808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

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