Organization Active NPI

Kore Rehab

  • Physical Therapist
  • Yucaipa, CA
National Provider Identifier
1063082899
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KORE REHAB
Practice address
31776 Yucaipa Blvd Ste 8
Yucaipa, CA 92399-1653
Phone
(916) 276-4621
NPI assigned
Jun 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristofer AuerNPI 1699357079
Title
Owner
Phone
(916) 276-4621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

31776 Yucaipa Blvd Ste 8
Yucaipa, CA 92399-1653

Mailing address

31776 Yucaipa Blvd Ste 8
Yucaipa, CA 92399-1653
Phone (916) 276-4621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210916001799 CA Part B Supplier - Clinic/Group Practice 6002212180 Receives reassigned benefits from 1 practitioner
Practice locations: Yucaipa, CA

National Provider Directory

National Provider Directory

Locations

31776 Yucaipa Blvd
Ste 1
Yucaipa, CA 92399
Phone (916) 276-4621

31776 Yucaipa Blvd
Ste 8
Yucaipa, CA 92399
Phone (916) 276-4621

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1063082899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31776 YUCAIPA BLVD STE 8",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923991653",
            "telephone_number": "916-276-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31776 YUCAIPA BLVD STE 8",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923991653",
            "telephone_number": "916-276-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORE REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "AUER",
        "authorized_official_first_name": "KRISTOFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-276-4621"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.