Individual provider Active NPI

Jonathan Todd, PT

  • Physical Therapist
  • Corona, CA
National Provider Identifier
1972871911
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
38405 Issued in CA
Practice address
2275 S Main St
Suite 102
Corona, CA 92882-5303
Phone
(951) 273-7742
NPI assigned
Dec 5, 2011
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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 38405 CA Primary

Addresses

Primary practice location

2275 S Main St
Suite 102
Corona, CA 92882-5303

Mailing address

2275 S Main St
Ste 102
Corona, CA 92882-5303
Phone (951) 500-0260

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120206000819 CA Practitioner - Physical Therapist in Private Practice 2961669734 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
Bodybasics Physical Therapy IncGroup PAC ID 2365413861, 15 clinicians

Practice addresses (Care Compare)

2275 S Main St
Suite 102
Corona, CA 92882-5303
Phone (951) 273-7742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38405CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bodybasics Physical Therapy, Inc. CurrentSince Dec 1, 2011 Accepting new patients
Bodybasics Physical Therapy, Inc. PastSince Dec 1, 2011 Accepting new patients

Locations

2275 S Main St
Ste 102
Corona, CA 92882
Phone (951) 273-7742

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1972871911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 S MAIN ST",
            "address_2": "STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825303",
            "telephone_number": "951-500-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 S MAIN ST",
            "address_2": "SUITE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825303",
            "telephone_number": "951-273-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "JONATHAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-05",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.