Organization Active NPI

Quality Rehab Inc

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1124276217
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
QUALITY REHAB INC
Practice address
3604 Galley Rd
Ste 200
Colorado Springs, CO 80909-4302
Phone
(719) 550-4613
Fax
(719) 375-8426
NPI assigned
Sep 3, 2008
Last updated
Sep 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Authorized official

Name
Jason Yisu Park, PT, DPTNPI 1447458369
Title
Ceo/ Owner
Phone
(719) 550-4613

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

3604 Galley Rd
Ste 200
Colorado Springs, CO 80909-4302

Mailing address

3604 Galley Rd
Ste 200
Colorado Springs, CO 80909-4302
Phone (719) 550-4613

Other practice location 1

3604 Galley Rd Ste 201
Colorado Springs, CO 80909-4301
Phone (719) 634-4548

Other identifiers 1

IdentifierTypeStateIssuer
54272785MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090110000036 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6406919950 Receives reassigned benefits from 3 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

1304 N Academy Blvd
Ste 108
Colorado Springs, CO 80909
Phone (719) 550-4613

3604 Galley Rd
Ste 201
Colorado Springs, CO 80909
Phone (719) 634-4548

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1124276217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 GALLEY RD",
            "address_2": "STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094302",
            "telephone_number": "719-550-4613",
            "fax_number": "719-375-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 GALLEY RD",
            "address_2": "STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094302",
            "telephone_number": "719-550-4613",
            "fax_number": "719-375-8426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3604 Galley Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809094301",
            "country_code": "US",
            "telephone_number": "719-634-4548",
            "fax_number": "719-638-4571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "QUALITY REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "YISU",
        "authorized_official_title_or_position": "CEO/ OWNER",
        "authorized_official_telephone_number": "719-550-4613",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54272785",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.