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 17 years ago. Clear Lake Physical Therapy Inc operates as a Multi-Specialty Group with one or more individual practitioners, 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.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1477502912, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477502912, enumerated 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.
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 verify.
