Individual provider Active NPI

Jeffrey Riepe, PT DPT ATC

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1952789794
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
295556 Issued in CA
Practice address
8830 S Sepulveda Blvd
Los Angeles, CA 90045-4833
Phone
(651) 353-1881
NPI assigned
May 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2000022201 MN
Physical Therapist 225100000X 295556 CA Primary

Addresses

Primary practice location

8830 S Sepulveda Blvd
Los Angeles, CA 90045-4833

Mailing address

8830 S Sepulveda Blvd
Los Angeles, CA 90045-4833
Phone (651) 353-1881

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
295556CAMDPhysical Therapist
2000022201MNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1952789794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8830 S SEPULVEDA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900454833",
            "telephone_number": "651-353-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8830 S SEPULVEDA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900454833",
            "telephone_number": "651-353-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEPE",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PT DPT ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-13",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2000022201",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "295556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 15, 2020; 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.