Axcend Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

AXCEND PHYSICAL THERAPY

Practice address

19015 Town Center Dr Ste 102
Apple Valley, CA 92308-8995

Phone

(760) 961-4240

Fax

(760) 961-4705

NPI assigned

Nov 9, 2018

Organization subpart

No

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

Authorized official

Name

Umesh C. Shah, M.D.NPI 1851465504

Title

Authorized Official / President

Phone

(909) 239-5692

Specialties & licenses 1

Addresses

Other names 1

• Axcend Physical Therapy Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Kavan Muneshbhai Shah, P.T.

  • Physical Therapist
  • Apple Valley, CA
  • NPI 1083957096
  Medicare reassignment NPD
• Umesh Shah, M.D.

  • Gastroenterology Physician
  • Chino, CA
  • NPI 1851465504
  NPD Authorized official

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1558839209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19015 TOWN CENTER DR STE 102",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923088995",
            "telephone_number": "760-961-4240",
            "fax_number": "760-961-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19015 TOWN CENTER DR STE 102",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923088995",
            "telephone_number": "760-961-4240",
            "fax_number": "760-961-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXCEND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-09",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "UMESH",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL / PRESIDENT",
        "authorized_official_telephone_number": "909-239-5692",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axcend Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Therapy Clinic/Center in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.