NPIMap

A Plus Pediatric Rehab, Inc.

Organization Active NPI Rehabilitation Clinic/Center · San Antonio, TX

NPI 1497997019 · NPPES record last updated Aug 2, 2022

Key facts

NPI
1497997019
Entity type
Organization (NPI type 2)
Primary specialty
Rehabilitation Clinic/Center 261QR0400X
Legal business name
A PLUS PEDIATRIC REHAB, INC.
Practice address
9514 Console Drive
Suite 102
San Antonio, TX 78229-2042
Phone
(210) 448-9111
Fax
(210) 308-9595
NPI assigned
Mar 27, 2009
Organization subpart
No

Authorized official

Name
Mr. Mohamed Ghannam
Title
Ceo
Phone
(210) 448-9111

Practitioners 47

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

View all 47

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110819000511 TX Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 8123164928 Practice locations: San Antonio, TX

National Provider Directory

Locations

9514 Console Dr
Ste 102
San Antonio, TX 78229
Phone (210) 448-9111

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Yes
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X 663890000 TX

Addresses

Primary practice location

9514 Console Drive
Suite 102
San Antonio, TX 78229-2042

Mailing address

9514 Console Drive
Suite 102
San Antonio, TX 78229-2042
Phone (210) 448-9111

Other practice location 1

1211 Arcadia Path
San Antonio, TX 78247
Phone (210) 448-9111

Other identifiers

IdentifierTypeStateIssuer
3132839-01MedicaidTX

Other names

  • A Plus Pediatrics Rehab Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 2, 2022.

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1497997019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9514 CONSOLE DRIVE",
            "address_2": "SUITE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292042",
            "telephone_number": "210-448-9111",
            "fax_number": "210-308-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9514 CONSOLE DRIVE",
            "address_2": "SUITE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292042",
            "telephone_number": "210-448-9111",
            "fax_number": "210-308-9595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 Arcadia Path",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78247",
            "country_code": "US",
            "telephone_number": "210-448-9111",
            "fax_number": "210-308-9595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "A PLUS PEDIATRIC REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-27",
        "last_updated": "2022-08-02",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "GHANNAM",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-448-9111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "TX",
            "license": "663890000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3132839-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Plus Pediatrics Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A Plus Pediatrics Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

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Sources for this page

Verify at the official NPI Registry.