Replenish Physical Therapy & Dance Performance PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REPLENISH PHYSICAL THERAPY & DANCE PERFORMANCE PC

Practice address

25830 Oak St Unit 7
Lomita, CA 90717-3121

Phone

(310) 922-3526

NPI assigned

Mar 14, 2024

Organization subpart

No

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

Authorized official

Name

Hilary Paige Gereaux Van Dixhorn, PT, DPTNPI 1720593494

Title

President

Phone

(310) 922-3526

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hilary Paige Gereaux Van Dixhorn

  • Physical Therapist
  • Lomita, CA
  • NPI 1720593494
  NPD Authorized official

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1215796032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 LOMITA BLVD # 512",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907171701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25830 OAK ST UNIT 7",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907173121",
            "telephone_number": "310-922-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REPLENISH PHYSICAL THERAPY & DANCE PERFORMANCE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-02-27",
        "status": "A",
        "authorized_official_last_name": "VAN DIXHORN",
        "authorized_official_first_name": "HILARY",
        "authorized_official_middle_name": "PAIGE GEREAUX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-922-3526",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darnell Houston Randolph
• Irram A Rao, M.D
• Red Sun Therapeutics, Inc.
• Remolina Dental Corp.
• Brianda Renteria
• Jose Rey, MFT
• Nelly J Reyes
• Riley Med Solutions LLC
• Leny Maritza Rodriguez
• Wendy Rodriguez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.