Organization Active NPI

Sports Chiro and Rehab

  • Physical Medicine & Rehabilitation Physician
  • Davie, FL
National Provider Identifier
1669984977
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SPORTS CHIRO AND REHAB
Practice address
5400 S University Dr Ste 603
Davie, FL 33328-5314
Phone
(954) 900-2942
Fax
(954) 451-3948
NPI assigned
Oct 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Authorized official

Name
Kim Testa
Title
Office Manager
Phone
(954) 451-3946

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH9220 FL
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

5400 S University Dr Ste 603
Davie, FL 33328-5314

Mailing address

5400 S University Dr Ste 603
Davie, FL 33328-5314
Phone (954) 900-2942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190725000402 FL Part B Supplier - Clinic/Group Practice 8426384678 Receives reassigned benefits from 2 practitioners
Practice locations: Davie, FL

National Provider Directory

National Provider Directory

Locations

5400 S University Dr
Ste 603
Davie, FL 33328
Phone (954) 378-8285

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1669984977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 603",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285314",
            "telephone_number": "954-900-2942",
            "fax_number": "954-451-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 603",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285314",
            "telephone_number": "954-900-2942",
            "fax_number": "954-451-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS CHIRO AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2019-05-01",
        "status": "A",
        "authorized_official_last_name": "TESTA",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-451-3946"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9220",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.