Individual provider Active NPI

Carey Laurent

  • Physical Therapist
  • Fullerton, CA
National Provider Identifier
1144716481
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1027 N Harbor Blvd Ste B
Fullerton, CA 92832-1362
Phone
(714) 870-8478
NPI assigned
Jul 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1027 N Harbor Blvd Ste B
Fullerton, CA 92832-1362

Mailing address

560 Martinez Dr
La Habra, CA 90631-5819
Phone (562) 665-0104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181210003341 CA Practitioner - Physical Therapist in Private Practice 1153665609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reekstin Enterprises Inc.Group PAC ID 3678603586, 13 clinicians
Core Total Body Physical Therapy PCGroup PAC ID 3678842663, 12 clinicians

Practice addresses (Care Compare)

1027 N Harbor Blvd
Suite B
Fullerton, CA 92832-1362
Phone (714) 870-8478

120 S Chaparral CT
Suite 150
Anaheim, CA 92808-2278
Phone (714) 998-9580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reekstin Enterprises Inc. Physical Therapist CurrentSince Oct 1, 2018 Accepting new patients
Core Total Body Physical Therapy, P.C. Physical Therapist CurrentSince Aug 1, 2021 Accepting new patients

Locations

120 S Chaparral Ct
Ste 150
Anaheim, CA 92808
Phone (714) 998-9580

1027 N Harbor Blvd
Ste B
Fullerton, CA 92832
Phone (714) 870-8478

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
C.O.R.E at HomeAnaheim, CA, CCN 757388 Home health agency 5% Or Greater Direct Ownership Interest (8.17%)
Corporate Officer (8.17%)
Corporate Director (8.17%)
May 1, 2024
May 1, 2024
May 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1144716481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 MARTINEZ DR",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906315819",
            "telephone_number": "562-665-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 N HARBOR BLVD STE B",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321362",
            "telephone_number": "714-870-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENT",
        "first_name": "CAREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.