Individual provider Active NPI

Christy N Effendie-Peterson, DPT

  • Physical Therapist
  • Carmichael, CA
National Provider Identifier
1972200202
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303630 Issued in CA
Practice address
6601 Madison Ave Ste 200
Carmichael, CA 95608-0600
Phone
(916) 965-8900
Fax
(916) 853-0259
NPI assigned
Feb 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 303630 CA Primary

Addresses

Primary practice location

6601 Madison Ave Ste 200
Carmichael, CA 95608-0600

Mailing address

6601 Madison Ave Ste 200
Carmichael, CA 95608-0600
Phone (916) 965-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230315000189 CA Practitioner - Physical Therapist in Private Practice 3678947611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mac Performance Physical Therapy IncGroup PAC ID 7810365608, 15 clinicians

Practice addresses (Care Compare)

691 E Bidwell St
Folsom, CA 95630-3120
Phone (916) 572-6162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303630CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Swanson McArthur Physical Therapy Physical Therapist CurrentSince Feb 6, 2023 Accepting new patients
Mac Performance Physical Therapy Inc Physical Therapist CurrentSince Dec 11, 2023 Accepting new patients

Locations

6601 Madison Ave
Ste 200
Carmichael, CA 95608
Phone (916) 965-8900

691 E Bidwell St
Folsom, CA 95630
Phone (916) 572-6162

Organizations & group practices 2

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": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1972200202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 MADISON AVE STE 200",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080600",
            "telephone_number": "916-965-8900",
            "fax_number": "916-853-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 MADISON AVE STE 200",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080600",
            "telephone_number": "916-965-8900",
            "fax_number": "916-853-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EFFENDIE-PETERSON",
        "first_name": "CHRISTY",
        "middle_name": "N",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.