Beach Pro Physical Medicine, Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

BEACH PRO PHYSICAL MEDICINE, INC

Practice address

8941 Adams Ave
Huntington Beach, CA 92646-3330

Phone

(714) 962-8818

Fax

(714) 962-8819

NPI assigned

Aug 11, 2020

Last updated

Aug 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jacquelyn Sammons, DONPI 1982732236

Title

President

Phone

(714) 962-8818

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 6

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.

• Jacquelyn Diane Sammons, D.O.

  • Obstetrics & Gynecology Physician
  • Anaheim, CA
  • NPI 1982732236
  Medicare reassignment Authorized official
• Robert Bruce Reynoso, D.C.

  • Chiropractor
  • Huntington Beach, CA
  • NPI 1568640399
  NPD
• John Tyler Richard

  • Chiropractor
  • Huntington Beach, CA
  • NPI 1003640103
  NPD
• Rodiel Kirby Layson Baloy II, MS, PT, CSCS

  • Physical Therapist
  • Huntington Beach, CA
  • NPI 1407030117
  NPD (past)
• Laura Nicole Tubbs, NP

  • Adult Health Nurse Practitioner
  • Palo Alto, CA
  • NPI 1336693324
  NPD (past)
• George Alecu

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1346091980

  Physical Therapy

  NPD (past)

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1447861653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8941 ADAMS AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926463330",
            "telephone_number": "714-962-8818",
            "fax_number": "714-962-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8941 ADAMS AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926463330",
            "telephone_number": "714-962-8818",
            "fax_number": "714-962-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH PRO PHYSICAL MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "SAMMONS",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-962-8818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beach Kids Dentistry-Nguyen PC (Beach Kids Dentistry)
• Beach Obstetrics & Gynecology Medical Group a Medical Corporation
• Beach Physicians Medical Group Inc
• Beach Point Physical Therapy
• Beach Point Physical Therapy (Health Pro Wellness Center)
• Beach Professional Pharmacy, Inc. (Beach Professional Pharmacy)
• Beach Street Rehab
• Beach Surgery Center Inc.
• Beach Surgical Medical Center LLC
• Beachside Optometry Germundsen-Family Partnership

• Physical Medicine & Rehabilitation Physician in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.