NPIMap

Organization Active NPI

Vibrantcare Outpatient Rehabilitation of California Inc

  • Physical Therapy Clinic/Center
  • Fairfield, CA
National Provider Identifier
1790789295
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
VIBRANTCARE OUTPATIENT REHABILITATION OF CALIFORNIA INC
Practice address
1411 Oliver Rd Ste 200
Fairfield, CA 94534-3429
Phone
(707) 428-1311
Fax
(707) 428-1354
NPI assigned
Jun 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Mr. David Smith
Title
Ceo
Phone
(916) 782-1212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1411 Oliver Rd Ste 200
Fairfield, CA 94534-3429

Mailing address

PO Box 840343
Los Angeles, CA 90084-0343
Phone (916) 789-8115

Other names 1

  • VibrantCare Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021003000000 CA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 9234046962 Practice locations: Concord, CA; Fairfield, CA

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Vibrantcare Outpatient Rehabilitation Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

3001 Dover Ave
Ste B
Fairfield, CA 94533
Phone (707) 428-1311

Practitioners & affiliated clinicians

Practitioners 2

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": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1790789295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840343",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900840343",
            "telephone_number": "916-789-8115",
            "fax_number": "916-773-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 OLIVER RD STE 200",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945343429",
            "telephone_number": "707-428-1311",
            "fax_number": "707-428-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANTCARE OUTPATIENT REHABILITATION OF CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-782-1212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VibrantCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VibrantCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.