NPIMap

Organization Active NPI

Innovative Senior Rehabilitation Services Inc.

Doing business as Innovative Senior Rehab

  • Physical Therapist
  • Stockton, CA
National Provider Identifier
1922160829
Registry record updated Jul 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
INNOVATIVE SENIOR REHABILITATION SERVICES INC.
Doing business as
Innovative Senior Rehab
Practice address
6725 Inglewood Ave
Stockton, CA 95207-3865
Phone
(209) 954-9022
Fax
(209) 954-9022
NPI assigned
Dec 15, 2006
Last updated
Jul 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2011

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

Authorized official

Name
Elizabeth Joy HadleyNPI 1689736597
Title
VP Cfo
Phone
(916) 690-0757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

6725 Inglewood Ave
Stockton, CA 95207-3865

Mailing address

222 W Pine St
Lodi, CA 95240-2020
Phone (209) 368-1009

Other identifiers 1

IdentifierTypeStateIssuer
CH1035OtherCARAILROAD MEDICARE PTAN

Other names 1

  • Innovative Senior Rehab Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310256000000",
    "number": "1922160829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W PINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952402020",
            "telephone_number": "209-368-1009",
            "fax_number": "209-368-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6725 INGLEWOOD AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073865",
            "telephone_number": "209-954-9022",
            "fax_number": "209-954-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SENIOR REHABILITATION SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-07-10",
        "status": "A",
        "authorized_official_last_name": "HADLEY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "VP CFO",
        "authorized_official_telephone_number": "916-690-0757"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "CH1035",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Senior Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2011; 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.