Shine Rehab LLC

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

Legal business name

SHINE REHAB LLC

Practice address

614 N Freeman St
Oceanside, CA 92054-2417

Phone

(321) 274-2745

NPI assigned

Oct 25, 2019

Organization subpart

No

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

Authorized official

Name

Matthew Griffis, PT

Title

Principal

Phone

(321) 274-2745

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1093358657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 N FREEMAN ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 N FREEMAN ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542417",
            "telephone_number": "321-274-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "GRIFFIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "321-274-2745",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Physical Therapist in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Geriatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.