Authentic Rehab LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

AUTHENTIC REHAB LLC

Practice address

2844 Shaughnessy Dr
Wellington, FL 33414-6496

Phone

(513) 280-0662

NPI assigned

Jan 9, 2022

Organization subpart

No

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

Authorized official

Name

Sandhya Koripalli Chiranjeevi, DPTNPI 1891025193

Title

Doctor in Physical Therapy

Phone

(513) 280-0662

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• Sandhya Koripalli Chiranjeevi, RPT

  • Physical Therapist
  • Livonia, MI
  • NPI 1891025193

  FL

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1641686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641686400000",
    "number": "1780345025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2844 SHAUGHNESSY DR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146496",
            "telephone_number": "513-280-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2844 SHAUGHNESSY DR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146496",
            "telephone_number": "513-280-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-09",
        "last_updated": "2022-01-09",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "KORIPALLI CHIRANJEEVI",
        "authorized_official_first_name": "SANDHYA",
        "authorized_official_title_or_position": "DOCTOR IN PHYSICAL THERAPY",
        "authorized_official_telephone_number": "513-280-0662",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aw Eyecare (Seaview Eyecare)

• Physical Therapy Clinic/Center in Wellington, FL
• Providers in Wellington, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2022; 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.