NPIMap

Organization Active NPI

Coastal Mobile Therapy a Professional Physical Therapy Corp

  • Physical Therapist
  • Oceanside, CA
National Provider Identifier
1962843078
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26133 Issued in CA
Legal business name
COASTAL MOBILE THERAPY A PROFESSIONAL PHYSICAL THERAPY CORP
Practice address
1630 Ridgeway St
Oceanside, CA 92054
Phone
(760) 688-9089
NPI assigned
Jul 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Authorized official

Name
Jason Swisher, PTNPI 1124241138
Title
President
Phone
(760) 688-9089

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
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 26133 CA Primary

Addresses

Primary practice location

1630 Ridgeway St
Oceanside, CA 92054

Mailing address

1630 Ridgeway St
Oceanside, CA 92054-5637
Phone (760) 688-9089

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140321001276 CA Part B Supplier - Clinic/Group Practice 0648401349 Receives reassigned benefits from 18 practitioners
Practice locations: Oceanside, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1962843078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 RIDGEWAY ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545637",
            "telephone_number": "760-688-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 RIDGEWAY ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92054",
            "telephone_number": "760-688-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MOBILE THERAPY A PROFESSIONAL PHYSICAL THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "SWISHER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-688-9089",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "26133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.