Individual provider Active NPI

Jeffrey Michael Olaughlin, PT, DPT

  • Physical Therapist
  • Sunnyvale, CA
National Provider Identifier
1962771063
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT39259 Issued in CA
Practice address
582 S Sunnyvale Ave
Sunnyvale, CA 94086-6125
Phone
(408) 523-3060
NPI assigned
Dec 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P13213 NC
Physical Therapist 225100000X J1-0002670 DE
Physical Therapist 225100000X PT39259 CA Primary

Addresses

Primary practice location

582 S Sunnyvale Ave
Sunnyvale, CA 94086-6125

Mailing address

582 S Sunnyvale Ave
Sunnyvale, CA 94086-6125
Phone (408) 523-3060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120208000317 NC Practitioner - Physical Therapist in Private Practice 9537326210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT39259CAMDPhysical Therapist
J1-0002670DEMDPhysical Therapist
P13213NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Mar 7, 2019 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Mar 7, 2019 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

211 Friday Center Dr
Ste 2057
Chapel Hill, NC 27517
Phone (984) 974-1281

590 Manning Dr
Chapel Hill, NC 27599
Phone (919) 966-0210

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

115 Oakdale Dr
Unit 8
Hillsborough, NC 27278
Phone (919) 451-1753

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1962771063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 S SUNNYVALE AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940866125",
            "telephone_number": "408-523-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 S SUNNYVALE AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940866125",
            "telephone_number": "408-523-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAUGHLIN",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-19",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P13213",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0002670",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT39259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.