NPIMap

Organization Active NPI

Rise Pacific Physical Therapy and Sports Medicine

  • Physical Therapy Clinic/Center
  • Thousand Oaks, CA
National Provider Identifier
1952855843
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
RISE PACIFIC PHYSICAL THERAPY AND SPORTS MEDICINE
Practice address
501 Marin St Ste 205
Thousand Oaks, CA 91360-4266
Phone
(757) 748-6003
Fax
(877) 287-1195
NPI assigned
Aug 8, 2016
Last updated
Jul 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Gina D Meyer, DPTNPI 1083638316
Title
President
Phone
(757) 748-6003

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X PT291493 CA
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

501 Marin St Ste 205
Thousand Oaks, CA 91360-4266

Mailing address

30025 Quail Run Dr
Agoura Hills, CA 91301-4068
Phone (757) 748-6003

Other names 1

  • Best Life Physical Therapy and Sports Medicine Davis Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200108000323 CA Part B Supplier - Clinic/Group Practice 1759662281 Receives reassigned benefits from 6 practitioners
Practice locations: Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

195 E Hillcrest Dr
Ste 114
Thousand Oaks, CA 91360
Phone (818) 318-2430

501 Marin St
Ste 205
Thousand Oaks, CA 91360
Phone (805) 495-3937

Practitioners & affiliated clinicians

Practitioners 8

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": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1952855843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30025 QUAIL RUN DR",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014068",
            "telephone_number": "757-748-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARIN ST STE 205",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604266",
            "telephone_number": "757-748-6003",
            "fax_number": "877-287-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE PACIFIC PHYSICAL THERAPY AND SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-748-6003",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT291493",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Best Life Physical Therapy and Sports Medicine Davis",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.