NPIMap

Organization Active NPI

Innovative Wellness Solutions Inc

Doing business as California Rehabilitation and Sports Therapy

  • Physical Therapist
  • Yorba Linda, CA
National Provider Identifier
1356367411
Registry record updated Dec 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
INNOVATIVE WELLNESS SOLUTIONS INC
Doing business as
California Rehabilitation and Sports Therapy
Practice address
19768 Yorba Linda Blvd
Yorba Linda, CA 92886-2801
Phone
(714) 693-0460
Fax
(714) 693-0444
NPI assigned
Jul 14, 2006
Last updated
Dec 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2017

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

Authorized official

Name
Mrs. Karin Bagwell
Title
Office Manager
Phone
(714) 693-0460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CA Primary

Addresses

Primary practice location

19768 Yorba Linda Blvd
Yorba Linda, CA 92886-2801

Mailing address

19768 Yorba Linda Blvd
Yorba Linda, CA 92886-2801

Other names 1

  • California Rehabilitation and Sports Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040206000964 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2961395462 Receives reassigned benefits from 12 practitioners
Practice locations: Yorba Linda, CA

National Provider Directory

National Provider Directory

Locations

19768 Yorba Linda Blvd
Yorba Linda, CA 92886
Phone (714) 693-0460

20655 Yorba Linda Blvd
Ste A
Yorba Linda, CA 92886
Phone (714) 693-0460

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514505600000",
    "number": "1356367411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19768 YORBA LINDA BLVD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19768 YORBA LINDA BLVD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862801",
            "telephone_number": "714-693-0460",
            "fax_number": "714-693-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE WELLNESS SOLUTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2017-12-29",
        "status": "A",
        "authorized_official_last_name": "BAGWELL",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-693-0460",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Rehabilitation and Sports Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.