Individual provider Active NPI

Karin Spruill I, P.T.

  • Physical Therapist
  • Buena Park, CA
National Provider Identifier
1982974481
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14715 Issued in CA
Practice address
6850 Lincoln Ave Ste 104
Buena Park, CA 90620-4179
Phone
(714) 699-1710
Fax
(714) 699-1712
NPI assigned
Dec 31, 2011
Last updated
May 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2019

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 14715 CA Primary

Addresses

Primary practice location

6850 Lincoln Ave Ste 104
Buena Park, CA 90620-4179

Mailing address

8455 Kington Way
Cypress, CA 90630-2341
Phone (714) 336-4151

Other practice location 1

8455 Kington Way
Cypress, CA 90630-2341
Phone (714) 336-4151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14715CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Sand Coast Rehab Physical Therapy Inc Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
St. Luke Medical Arts Inc Past Accepting new patients

Locations

22995 Mill Creek Dr
Ste A
Laguna Hills, CA 92653

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, 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": "1325289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1982974481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8455 KINGTON WAY",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906302341",
            "telephone_number": "714-336-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 LINCOLN AVE STE 104",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204179",
            "telephone_number": "714-699-1710",
            "fax_number": "714-699-1712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8455 Kington Way",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "CA",
            "postal_code": "906302341",
            "country_code": "US",
            "telephone_number": "714-336-4151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPRUILL",
        "first_name": "KARIN",
        "name_suffix": "I",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-31",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "14715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.