SPORTS INJURY PHYSICAL THERAPY, INC (NPI# 1073603858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073603858 |
| Entity Type | Organization |
| Organization Name | SPORTS INJURY PHYSICAL THERAPY, INC |
| Other Organization Name | PROFESSIONAL ORTHOPEDIC AND SPORTS CARE |
| Practice Address |
801 S Raymond Ave Pasadena CA 91105-3223 |
| Practice Telephone | 6263560599 |
| Practice Fax Number | 6263560570 |
| Mailing Telephone | 6263560599 |
| Mailing Fax Number | 6263560570 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-05-13 |
| Authorized Official Name | MR. KEVIN LEE WENTZ (OWNER) |
| Authorized Official Telephone | 6263560599 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
WPT21776B | CA | Ambulatory Health Care Facilities |
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
WPT27120B | CA | Ambulatory Health Care Facilities |
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
WPT20125B | CA | Ambulatory Health Care Facilities |
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
WPT14957B | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Professional Orthopedic and Sports Care | Doing Business As Name - Organization |
| Street Address |
801 S RAYMOND AVE |
| City | PASADENA |
| State | CA |
| Zip Code | 91105-3223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861581795 | Kevin Lee Wentz | Physical Therapist | 801 S Raymond Ave, Pasadena, CA 91105-3223 | 2006-10-11 |
| 1366087165 | Tara Rose Orourke | Physical Therapist | 801 S Raymond Ave, Pasadena, CA 91105-3223 | 2019-11-15 |
| 1265936710 | Michael Joseph | Physical Therapist | 801 S Raymond Ave, Pasadena, CA 91105-3223 | 2018-03-20 |
| 1215445168 | Stephen Getz | Physical Therapist | 801 S Raymond Ave, Pasadena, CA 91105-3223 | 2018-01-12 |
| 1871978809 | Edgar Avena Jr. | Physical Therapist | 801 S Raymond Ave, Pasadena, CA 91105-3223 | 2015-07-20 |
| 1255579348 | Christopher Jay Butler | Physical Therapist | 801 S Raymond Ave, Pasadena, CA 91105-3223 | 2009-01-27 |
| 1053492751 | Amado Jose Garcia | Physical Therapist | 801 S Raymond Ave, Pasadena, CA 91105-3223 | 2006-10-18 |
| 1376632273 | Karen Maria Corriveau | Physical Therapist | 801 S Raymond Ave, Pasadena, CA 91105-3223 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451697 | Tonya Michlin | Registered Nurse | 800 Fairmount Ave Ste 110, Pasadena, CA 91105 | 2018-09-17 |
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1548778541 | Elias & Jun Dental Corp | Dentist | 301 S. Fair Oaks Ave., Ste 107, Pasadena, CA 91105 | 2018-01-12 |
| 1013429745 | Whitney Catalano | Dietitian, Registered | 100 S Orange Grove Blvd, 103, Pasadena, CA 91105 | 2017-11-03 |
| 1518485630 | Marlon O Miller | Counselor | 1020 South Arroyo Parkway, Pasadena, CA 91105 | 2017-09-08 |
| 1316469976 | Alexandra Scott | Speech-Language Pathologist | 235 La Vereda Road, Pasadena, CA 91105 | 2017-07-14 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1427598390 | Melina Gomez Loza | Licensed Vocational Nurse | 66 Hilburt St #2, Pasadena, CA 91105 | 2017-02-27 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1922554245 | Daniel Joseph Ybarra | Student in an Organized Health Care Education/Training Program | 100 W. California Blvd. Pasadena, Ca 91105, Pasadena, CA 91105 | 2016-08-28 |
| Find all providers in zip 91105 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912521642 | Rose Bowl Aquatics Center | Clinic/Center | 360 N Arroyo Blvd, Pasadena, CA 91103-3201 | 2020-05-28 |
| 1215594981 | Aim Physical Therapy, Inc. | Clinic/Center | 1021 E Walnut St Ste 101, Pasadena, CA 91106-1479 | 2019-05-28 |
| 1558874719 | Julia Hayes | Clinic/Center | 180 S Madison Ave Apt 4, Pasadena, CA 91101-2573 | 2017-11-09 |
| 1669787495 | Arroyo Physical Therapy | Clinic/Center | 1720 E Washington Blvd, 208, Pasadena, CA 91104-2779 | 2010-08-17 |
| 1619122819 | Kimberly J. Bozart, Physical Therapy, A Professional Corporation | Clinic/Center | 345 S Lake Ave, Suite 201, Pasadena, CA 91101-5030 | 2008-12-02 |
| 1417111873 | Occupational Health Centers of California, A Medical Corporation | Clinic/Center | 177 E Colorado Blvd, Pasadena, CA 91105-1936 | 2008-07-15 |
| 1033395405 | Select Physical Therapy Holdings Inc | Clinic/Center | 301 N Lake Ave, Suite 201, Pasadena, CA 91101-4107 | 2008-01-16 |
| 1386827384 | Therapy Right | Clinic/Center | 615 Harris Ave, Pasadena, TX 77506-3114 | 2007-12-12 |
| 1588865877 | Perry Health & Rehabilitation PC | Clinic/Center | 1001 Fairmont Pkwy Ste L, Pasadena, TX 77504-2970 | 2007-05-31 |
| 1427163237 | Puno Physical Therapy Services, Inc | Clinic/Center | 750 E Green St, 308, Pasadena, CA 91101-2120 | 2006-08-20 |
| Find all providers in PASADENA | ||||
Please comment or provide details below to improve the information on SPORTS INJURY PHYSICAL THERAPY, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.