NPIMap

Organization Active NPI

Angelina Rehabilitation Center, LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Lufkin, TX
National Provider Identifier
1912089962
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
License
1082055 Issued in TX
Legal business name
ANGELINA REHABILITATION CENTER, LLC
Practice address
402 S John Redditt Dr
Lufkin, TX 75904-3107
Phone
(936) 632-2107
Fax
(936) 632-2108
NPI assigned
Oct 19, 2006
Last updated
Jan 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
Dr. Vinod R Sohini, DPT
Title
Owner
Phone
(936) 632-2107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X 1082055 TX Primary

Addresses

Primary practice location

402 S John Redditt Dr
Lufkin, TX 75904-3107

Mailing address

402 S John Redditt Dr
Lufkin, TX 75904-3107
Phone (936) 632-2107

Other identifiers 1

IdentifierTypeStateIssuer
454887OtherTXMEDICARE PART A ID - CORF

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120927000722 TX Part A Provider - Comprehensive Outpatient Rehabilitation Facility 6901834795 Practice locations: Lufkin, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912089962. Details of each certification follow.

  • CCN 454887 Comprehensive outpatient rehabilitation facility · Active · Name & address match · Details

Comprehensive outpatient rehabilitation facility certification: CCN 454887

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ANGELINA REHABILITATION CENTER, LLC
Certification status
Active
Provider type (POS)
Comprehensive outpatient rehabilitation facility
Participating since
Oct 10, 2013
Last certification
Apr 10, 2018
Ownership / control type
Proprietary
Facility address
402 S John Redditt Drive
Lufkin, TX 75904

National Provider Directory

National Provider Directory

Locations

1405 Turtle Creek Dr
Lufkin, TX 75904
Phone (936) 632-2107

402 S John Redditt Dr
Lufkin, TX 75904
Phone (936) 632-2107

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1912089962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043107",
            "telephone_number": "936-632-2107",
            "fax_number": "936-632-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043107",
            "telephone_number": "936-632-2107",
            "fax_number": "936-632-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELINA REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "SOHINI",
        "authorized_official_first_name": "VINOD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-632-2107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "TX",
            "license": "1082055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART A ID - CORF",
            "identifier": "454887",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.