Restore Sports Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

RESTORE SPORTS PHYSICAL THERAPY, INC.

Practice address

3505 Madison St Ste 102
Riverside, CA 92504-3785

Phone

(951) 329-3928

Fax

(951) 374-0621

NPI assigned

Nov 6, 2018

Organization subpart

No

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

Authorized official

Name

Erik Richard Salley, PT, DPTNPI 1356325542

Title

President

Phone

(951) 312-2843

Specialties & licenses 1

Addresses

Other names 1

• Restore Performance Institute Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Erik Richard Salley, PT DPT MA OCS CMDT

  • Physical Therapist
  • Riverside, CA
  • NPI 1356325542
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1407324502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 MADISON ST STE 102",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043785",
            "telephone_number": "951-329-3928",
            "fax_number": "951-374-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 MADISON ST STE 102",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043785",
            "telephone_number": "951-329-3928",
            "fax_number": "951-374-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE SPORTS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "SALLEY",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-312-2843",
        "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": [
        {
            "organization_name": "Restore Performance Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Restore Performance Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.