GOLD COAST PHYSICAL THERAPY AND SPORTS TRAINING
Complete NPI Record 1013203975
Physical Therapist in Smithtown, NY
Active since June 20, 2011
Complete NPI Dataset
This page contains the complete raw NPPES record for Gold Coast Physical Therapy And Sports Training (NPI 1013203975), a physical therapist organization in Smithtown, NY. All 35 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1013203975 Field 1/35
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/35
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/35
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: GOLD COAST PHYSICAL THERAPISTS & THERAPY ASSISTANTS Field 4/35
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: GOLD COAST PHYSICAL THERAPY AND SPORTS TRAINING Field 5/35
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 3 Field 6/35
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: 755 NEW YORK AVE Field 7/35
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Second Line Business Mailing Address: SUITE 106 Field 8/35
- The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
- Provider Business Mailing Address City Name: HUNTINGTON Field 9/35
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: NY Field 10/35
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 11743 Field 11/35
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 12/35
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 6313517676 Field 13/35
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 6313517667 Field 14/35
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 309 MIDDLE COUNTRY ROAD Field 15/35
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Second Line Business Practice Location Address: SUITE 202 Field 16/35
- The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: SMITHTOWN Field 17/35
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: NY Field 18/35
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 11787 Field 19/35
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 20/35
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 6316565665 Field 21/35
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 6316565664 Field 22/35
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: STRATTON Field 25/35
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: KATHLEEN Field 26/35
- The first name of the authorized official.
- Authorized Official Middle Name: S Field 27/35
- The middle name of the authorized official.
- Authorized Official Title or Position: CREDENTALING Field 28/35
- The title or position of the authorized official.
- Authorized Official Telephone Number: 6312627855 Field 29/35
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 225100000X Field 30/35
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 31/35
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: Y Field 32/35
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Parent Organization LBN: GOLD COAST PHYSICAL THERAPISTS AND THERAPY ASSISTANTS Field 33/35
- The Legal Business Name (LBN) of the parent organization, if the provider is a subpart of a larger entity. This field identifies the official registered name of the parent company or organization under which the provider operates.
- Parent Organization TIN: Not available Field 34/35
- The Taxpayer Identification Number (TIN) of the parent organization, provided when the provider is a subpart of a larger entity. This field identifies the federal tax ID used by the parent organization for official and billing purposes.
- Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP Field 35/35
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
QOWLX1 Medicare UPIN
Identifier 1/1State: NY
Medicare UPIN (Unique Physician Identification Number): A legacy six-character alphanumeric identifier previously issued by Medicare to individual physicians before being retired and replaced by the NPI system.
Medicare UPIN (Unique Physician Identification Number): A legacy six-character alphanumeric identifier previously issued by Medicare to individual physicians before being retired and replaced by the NPI system.
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