Repair Physical Therapy Inc.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT 38002 Issued in CA

Legal business name

REPAIR PHYSICAL THERAPY INC.

Practice address

16561 Bolsa Chica St Ste 107
Huntington Beach, CA 92649-3574

Phone

(714) 377-4313

Fax

(714) 377-4313

NPI assigned

Jun 5, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Chad Stephen Beauchamp, DPT

Title

Doctor of Physical Therapy/ Owner

Phone

(310) 721-1082

Specialties & licenses 2

Addresses

Tax ID family

Repair Sports Institute3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Repair Physical Therapy Inc.

  • Physical Therapist
  • Newport Beach, CA
  • NPI 1437681459
  NPD tax ID
• Repair Sports Institute

  • Sports Physical Therapist
  • Anaheim, CA
  • NPI 1851844708
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Repair Physical Therapy Inc.

  • Physical Therapist
  • Newport Beach, CA
  • NPI 1437681459
  NPPES parent name

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1497135255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16561 BOLSA CHICA ST STE 107",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493574",
            "telephone_number": "714-377-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16561 BOLSA CHICA ST STE 107",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493574",
            "telephone_number": "714-377-4313",
            "fax_number": "714-377-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REPAIR PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-05",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "BEAUCHAMP",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY/ OWNER",
        "authorized_official_telephone_number": "310-721-1082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT 38002",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT 38002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Rendin, MD
• Noemi Rendon
• Bianca Renteria Balmaceda
• Kathleen Renteria, SUDRC-19523
• Tyler Renteria
• Elsie Resendiz
• Retina Institute of California Medical Group, a California Medical Par
• Paulina Reveles, PA-C
• Revival Mental Health LLC
• Suzanne Reyes-Ingwersen, DPT

• Orthopedic Physical Therapist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.