Optimus Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

OPTIMUS REHAB LLC

Practice address

5113 Spring Brook Dr
Corpus Christi, TX 78413-5629

Phone

(361) 248-2004

Fax

(888) 499-1749

NPI assigned

Jan 8, 2020

Organization subpart

No

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

Authorized official

Name

Engelbert De Vera, PT

Title

President, PT

Phone

(361) 248-2004

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1891335741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61160",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784661160",
            "telephone_number": "361-884-2904",
            "fax_number": "361-857-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 SPRING BROOK DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784135629",
            "telephone_number": "361-248-2004",
            "fax_number": "888-499-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "DE VERA",
        "authorized_official_first_name": "ENGELBERT",
        "authorized_official_title_or_position": "PRESIDENT, PT",
        "authorized_official_telephone_number": "361-248-2004",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS",
            "identifier": "1125821",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.