Individual provider Active NPI

Keith R. Strother, PT

  • Orthopedic Physical Therapist
  • Huntington Beach, CA
National Provider Identifier
1972525335
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
13554 Issued in CA
Practice address
19891 Beach Blvd
Suite 105
Huntington Beach, CA 92648-3209
Phone
(714) 536-9700
Fax
(714) 536-9701
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 13554 CA Primary

Addresses

Primary practice location

19891 Beach Blvd
Suite 105
Huntington Beach, CA 92648-3209

Mailing address

19891 Beach Blvd
Suite 105
Huntington Beach, CA 92648-3209
Phone (714) 536-9700

Other identifiers 1

IdentifierTypeStateIssuer
PT13554OtherCALEGACY PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100521000308 CA Practitioner - Physical Therapist in Private Practice 4385552819 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Home Physical Therapy Providers & Wellness Inc. Orthopedic CurrentSince Dec 20, 2022 Accepting new patients
Eagle Physical Therapy of Huntington Beach CurrentSince Apr 5, 2010 Accepting new patients
Homeworks Physical Therapy Inc Orthopedic CurrentSince Jul 31, 2015 Accepting new patients

Locations

403 W 5th Ave
Ste C
Escondido, CA 92025
Phone (760) 536-2377

1611 S Melrose Dr
#311
Vista, CA 92081

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1972525335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19891 BEACH BLVD",
            "address_2": "SUITE 105",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926483209",
            "telephone_number": "714-536-9700",
            "fax_number": "714-536-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19891 BEACH BLVD",
            "address_2": "SUITE 105",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926483209",
            "telephone_number": "714-536-9700",
            "fax_number": "714-536-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROTHER",
        "first_name": "KEITH",
        "middle_name": "R.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "13554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGACY PIN",
            "identifier": "PT13554",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.