NPIMap

Organization Active NPI

Sports, Orthopedics & Active Rehabilitation, Inc.

  • Physical Therapist
  • Tamuning, GU
National Provider Identifier
1356550883
Registry record updated Oct 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
GUAMPT016 Issued in GU
Legal business name
SPORTS, ORTHOPEDICS & ACTIVE REHABILITATION, INC.
Practice address
224 Farenholt Ave
Ur 1 Building
Tamuning, GU 96913-3224
Phone
(671) 647-0110
Fax
(671) 647-0112
NPI assigned
May 22, 2007
Last updated
Oct 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2010

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

Authorized official

Name
Julienne R Duenas, PT, DPTNPI 1972713402
Title
President
Phone
(671) 647-0110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X GUAMPT016 GU Primary

Addresses

Primary practice location

224 Farenholt Ave
Ur 1 Building
Tamuning, GU 96913-3224

Mailing address

224 Farenholt Ave
Ur 1 Building
Tamuning, GU 96913-3224
Phone (671) 647-0110

Other names 1

  • SOAR Physical Therapy Other name

National Provider Directory

National Provider Directory
Tax ID family
Soar Physical Therapy2 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.

Locations

224 Farenholt Ave
#1
Tamuning, GU 96913
Phone (671) 647-0110

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287878400000",
    "number": "1356550883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 FARENHOLT AVE",
            "address_2": "UR 1 BUILDING",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133224",
            "telephone_number": "671-647-0110",
            "fax_number": "671-647-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 FARENHOLT AVE",
            "address_2": "UR 1 BUILDING",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133224",
            "telephone_number": "671-647-0110",
            "fax_number": "671-647-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS, ORTHOPEDICS & ACTIVE REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2010-10-24",
        "status": "A",
        "authorized_official_last_name": "DUENAS",
        "authorized_official_first_name": "JULIENNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "671-647-0110",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "GU",
            "license": "GUAMPT016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOAR Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2010; 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.