CLEAR LAKE PHYSICAL THERAPY INC
NPI 1477502912
Physical Therapist in Clearlake, CA
NPI Status: Active since May 10, 2006
Contact Information
14855 OLYMPIC DR
CLEARLAKE, CA
ZIP 95422
Phone: (707) 994-7248
Fax: (707) 994-7248
- Organization
- Physical Therapist
- CLIA Number: 05D2017138
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 05-22-2026
About CLEAR LAKE PHYSICAL THERAPY INC
This page provides the complete NPI Profile along with additional information for Clear Lake Physical Therapy Inc, a provider established in Clearlake, California operating as a Physical Therapist. The healthcare provider is registered in the NPI registry with number 1477502912 assigned on May 2006. The practitioner's primary taxonomy code is 225100000X with license number PT17230 (CA). The provider is registered as an organization and their NPI record was last updated 16 years ago. Clear Lake Physical Therapy Inc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Lawrence Hosmer Hurst Pt (Owner)
- NPI
- 1477502912
- Provider Name
- CLEAR LAKE PHYSICAL THERAPY INC
- Entity Type
- Organization
- Location Address
- 14855 OLYMPIC DR CLEARLAKE, CA 95422
- Location Phone
- (707) 994-7248
- Location Fax
- (707) 994-7248
- Mailing Address
- 14855 OLYMPIC DR PO BOX 3288 CLEARLAKE, CA 95422
- Mailing Phone
- (707) 994-7248
- Mailing Fax
- (707) 994-7248
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-10-2006
- Last Update Date
- 12-07-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physical Therapist
- Taxonomy Code
- 225100000X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- License No.
- PT17230
- License State
- CA
- Taxonomy Description
- Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| GPT001040 | MEDICAID (05) | CA | |
| ZZZ19896Z | MEDICARE PIN (08) | CA | |
| 4524620001 | MEDICARE NSC (07) | CA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2017138
- Facility Type
- Community Clinic
- Certificate Effective Date
- December 06, 2010
- Certificate Expiration Date
- May 22, 2026
- Laboratory Director
- TIFFANY CHAMBERS
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Clear Lake Physical Therapy Inc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
Reviews for CLEAR LAKE PHYSICAL THERAPY INC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 7 | 7 | 5 | 0 | 2 | 9 | 1 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 14 | 7 | 10 | 0 | 4 | 9 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 4 + 7 + 1 + 0 + 0 + 4 + 9 + 2 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1477502912 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1619284411 | SARAH VESELING Individual | Physical Therapist | 14855 OLYMPIC DR CLEARLAKE, CA 95422 (707) 994-7248 |
| 1306330600 | NYSSA ROSINA MIDDEN Individual | Physical Therapist | 14855 OLYMPIC DR CLEARLAKE, CA 95422 (707) 995-4888 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477502912, enumerated in the NPI registry as an "organization" on May 10, 2006
The provider is located at 14855 Olympic Dr Clearlake, Ca 95422 and the phone number is (707) 994-7248
This medical organization specializes in Physical Therapist with taxonomy code 225100000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 05D2017138 for a "community clinic" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on May 10, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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