Recreate Physical Therapy & Wellness, PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RECREATE PHYSICAL THERAPY & WELLNESS, PC

Doing business as

Big Bear Physical Therapy & Wellness

Practice address

2108 N St Ste N
Sacramento, CA 95816-5712

Phone

(909) 659-3551

NPI assigned

Jul 10, 2022

Organization subpart

No

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

Authorized official

Name

Thomas Bradley, DPT

Title

Chief Executive Officer

Phone

(909) 659-3551

Specialties & licenses 1

Addresses

Other names 1

• Big Bear Physical Therapy & Wellness Doing business as

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

{
    "created_epoch": "1657411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657411200000",
    "number": "1821722588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120821",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923158946",
            "telephone_number": "909-659-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 N ST STE N",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165712",
            "telephone_number": "909-659-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECREATE PHYSICAL THERAPY & WELLNESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-10",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "909-659-3551",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Bear Physical Therapy & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kasidee Reconsal
• Desiree Andrea Record, DDS
• Rene Record
• Robert E Record, PH.D
• Recovercare, LLC
• Clayton Thomas Rector Jr., PHYSICIAN ASSISTANT
• Red Leaf Psychology, Inc.
• Red Onion Mobility Transport LLC
• Carl Red, R.PH.
• Jarad Reddekopp, ACNP-BC

• Physical Therapy Clinic/Center in Sacramento, CA
• Providers in Sacramento, 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 Jul 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.