Visalia Sport and Spine Rehabilitation Center Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

VISALIA SPORT AND SPINE REHABILITATION CENTER INC

Practice address

3530 W Mineral King Ave
Suite D
Visalia, CA 93291

Phone

(559) 625-2777

Fax

(559) 625-3373

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Quentin Heath Johnson, PTNPI 1346257797

Title

President Cfo Ceo

Phone

(559) 625-2777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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.

• Quentin Heath Johnson, PT

  • Physical Therapist
  • Nisalia, CA
  • NPI 1346257797
  Authorized official Same address or phone
• Brian Monty, OTR CHT

  • Occupational Therapist
  • Visalia, CA
  • NPI 1578789400
  NPD (past)
• Jodi Lynne Pegg, MPT

  • Physical Therapist
  • Visalia, CA
  • NPI 1578570925
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184639809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 W MINERAL KING AVE",
            "address_2": "SUITE D",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "93291",
            "telephone_number": "559-625-2777",
            "fax_number": "559-625-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 W MINERAL KING AVE",
            "address_2": "SUITE D",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "93291",
            "telephone_number": "559-625-2777",
            "fax_number": "559-625-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISALIA SPORT AND SPINE REHABILITATION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "QUENTIN",
        "authorized_official_middle_name": "HEATH",
        "authorized_official_title_or_position": "PRESIDENT CFO CEO",
        "authorized_official_telephone_number": "559-625-2777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ08071Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Visalia Primary Care Nursing Inc
• Visalia Recovery Center
• Visalia Rehab Group Inc
• Visalia Rehabilitative Medicine, Inc (Peak Physical Medicine)
• Visalia Rescue Mission
• Visalia Unified School District
• Visalia Vascular Institute Inc
• Visalia Walk in Medical Clinic Inc
• Visalia Women's Specialty Medical Group, Inc
• Visalia Youth Services

• Physical Therapist in Visalia, CA
• Providers in Visalia, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.