NPIMap

Organization Active NPI

Stithem & Johnson Physical Therapy, Inc.

Doing business as Orthopaedic and Sports Physical Therapy

  • Physical Therapy Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1982689675
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
STITHEM & JOHNSON PHYSICAL THERAPY, INC.
Doing business as
Orthopaedic and Sports Physical Therapy
Practice address
795 Farmers LN
Santa Rosa, CA 95405-6718
Phone
(707) 571-7615
Fax
(707) 571-8601
NPI assigned
Dec 14, 2005
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Mrs. Megan Sierra Newhall, B.A.
Title
VP of Admin
Phone
(707) 571-7615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

795 Farmers LN
Santa Rosa, CA 95405-6718

Mailing address

795 Farmers LN
Santa Rosa, CA 95405-6718
Phone (707) 571-7615

Other identifiers 1

IdentifierTypeStateIssuer
DA6103OtherCARAILROAD MEDICARE PTAN

Other names 1

  • Orthopaedic and Sports Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000745 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7214836600 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Rosa, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Orthopaedic and Sports Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

795 Farmers Ln
Santa Rosa, CA 95405
Phone (707) 571-7615

795 Farmers Ln
Ste 10
Santa Rosa, CA 95405
Phone (707) 571-7615

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1982689675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 FARMERS LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056718",
            "telephone_number": "707-571-7615",
            "fax_number": "707-571-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 FARMERS LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056718",
            "telephone_number": "707-571-7615",
            "fax_number": "707-571-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STITHEM & JOHNSON PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "NEWHALL",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "SIERRA",
        "authorized_official_title_or_position": "VP OF ADMIN",
        "authorized_official_telephone_number": "707-571-7615",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DA6103",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopaedic and Sports Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.