NPIMap

Organization Active NPI

Novacare Outpatient Rehabilitation of California Inc

  • Physical Therapy Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1366446916
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NOVACARE OUTPATIENT REHABILITATION OF CALIFORNIA INC
Practice address
1211 N Dutton Ave
Ste G
Santa Rosa, CA 95401-4638
Phone
(707) 579-1411
NPI assigned
Jun 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David Smith
Title
Ceo
Phone
(916) 782-1212

Specialties & licenses 1

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

Addresses

Primary practice location

1211 N Dutton Ave
Ste G
Santa Rosa, CA 95401-4638

Mailing address

1090 Sunrise Ave
Ste 140
Roseville, CA 95661-4466
Phone (916) 782-1212

Other names 1

  • NovaCare Outpatient Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vibrantcare Outpatient Rehabilitation Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366446916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 SUNRISE AVE",
            "address_2": "STE 140",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614466",
            "telephone_number": "916-782-1212",
            "fax_number": "916-773-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 N DUTTON AVE",
            "address_2": "STE G",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014638",
            "telephone_number": "707-579-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVACARE OUTPATIENT REHABILITATION OF CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-782-1212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Outpatient Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • 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.