Organization Active NPI

Kaweah Rehab Group Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Visalia, CA
National Provider Identifier
1770039703
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
A143883 Issued in CA
Legal business name
KAWEAH REHAB GROUP INC
Practice address
840 S Akers St
Visalia, CA 93277-8309
Phone
(559) 300-9777
Fax
(559) 750-4777
NPI assigned
Aug 30, 2016
Last updated
Aug 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Ashraf Ghaly, MD
Title
Partner
Phone
(559) 300-9777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A143883 CA Primary

Addresses

Primary practice location

840 S Akers St
Visalia, CA 93277-8309

Mailing address

PO Box 6236
Visalia, CA 93290-6236
Phone (559) 300-9777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161018001516 CA Part B Supplier - Clinic/Group Practice 1052609419 Receives reassigned benefits from 3 practitioners
Practice locations: Visalia, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1770039703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6236",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932906236",
            "telephone_number": "559-300-9777",
            "fax_number": "559-750-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S AKERS ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932778309",
            "telephone_number": "559-300-9777",
            "fax_number": "559-750-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAWEAH REHAB GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "GHALY",
        "authorized_official_first_name": "ASHRAF",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "559-300-9777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A143883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.