NPIMap

Organization Active NPI

Rehab Managed Care of Arizona, Inc

Doing business as VibrantCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Grand Prairie, TX
National Provider Identifier
1205679164
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
REHAB MANAGED CARE OF ARIZONA, INC
Doing business as
VibrantCare Rehabilitation
Practice address
2801 Osler Dr Ste 122
Grand Prairie, TX 75051-1059
Phone
(469) 515-8150
Fax
(469) 225-9964
NPI assigned
Jun 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
Cynthia McCormick
Title
Vice President of Revenue Cycle MGT
Phone
(916) 789-8115

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

2801 Osler Dr Ste 122
Grand Prairie, TX 75051-1059

Mailing address

14090 Southwest Fwy Ste 101
Sugar Land, TX 77478-3678
Phone (916) 789-8115

Other names 1

  • VibrantCare Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240709000392 TX Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 0345637450 Practice locations: Grand Prairie, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205679164. Details of each certification follow.

  • CCN 676799 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 676799

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
VIBRANTCARE REHABILITATION
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Oct 28, 2024
Last certification
Oct 28, 2024
Ownership / control type
Proprietary
Facility address
2801 Osler Dr Ste 122
Grand Prairie, TX 75051

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Rehab Managed Care of Arizona Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1205679164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14090 SOUTHWEST FWY STE 101",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783678",
            "telephone_number": "916-789-8115",
            "fax_number": "916-773-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 OSLER DR STE 122",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511059",
            "telephone_number": "469-515-8150",
            "fax_number": "469-225-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB MANAGED CARE OF ARIZONA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "VICE PRESIDENT OF REVENUE CYCLE MGT",
        "authorized_official_telephone_number": "916-789-8115"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VibrantCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.