Organization Active NPI

Fix Medical Group PC

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1174251300
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FIX MEDICAL GROUP PC
Practice address
5030 Camino de la Siesta Ste 404
San Diego, CA 92108-3120
Phone
(858) 248-5060
Fax
(619) 297-6901
NPI assigned
Aug 15, 2022
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Jesika Casey
Title
Case Manager
Phone
(858) 248-5060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

5030 Camino de la Siesta Ste 404
San Diego, CA 92108-3120

Mailing address

5030 Camino de la Siesta Ste 404
San Diego, CA 92108-3120
Phone (858) 248-5060

Other practice location 1

11717 Bernardo Plaza Ct Ste 102
San Diego, CA 92128-2419
Phone (619) 295-9791

Other names 1

  • Rejuvenate Medical Group Inc Former legal business name

National Provider Directory

National Provider Directory

Locations

11717 Bernardo Plaza Ct
Ste 102
San Diego, CA 92128
Phone (619) 295-9791

Practitioners & affiliated clinicians

Practitioners 1

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": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1174251300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CAMINO DE LA SIESTA STE 404",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083120",
            "telephone_number": "858-248-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 CAMINO DE LA SIESTA STE 404",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083120",
            "telephone_number": "858-248-5060",
            "fax_number": "619-297-6901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11717 Bernardo Plaza Ct Ste 102",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921282419",
            "country_code": "US",
            "telephone_number": "619-295-9791",
            "fax_number": "619-297-6901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FIX MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "JESIKA",
        "authorized_official_title_or_position": "CASE MANAGER",
        "authorized_official_telephone_number": "858-248-5060"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rejuvenate Medical Group Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.