NPIMap

Organization Active NPI

Shriners Hospitals for Children

Doing business as Shriners for Children Rehabilitation Clinic

  • Rehabilitation Clinic/Center
  • Pasadena, CA
National Provider Identifier
1972934008
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SHRINERS HOSPITALS FOR CHILDREN
Doing business as
Shriners for Children Rehabilitation Clinic
Practice address
909 S Fair Oaks Ave
Pasadena, CA 91105-2625
Phone
(213) 388-3151
Fax
(213) 387-7528
NPI assigned
Nov 27, 2013
Last updated
May 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Jerry G. Gantt
Title
President, Shriners Hospitals for
Phone
(813) 281-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

909 S Fair Oaks Ave
Pasadena, CA 91105-2625

Mailing address

PO Box 8500
P. O. Box #7642
Philadelphia, PA 19178-7642
Phone (213) 388-3151

Other names 1

  • Shriners for Children Rehabilitation Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131115001486 CA Part B Supplier - Clinic/Group Practice 9133031933 Receives reassigned benefits from 35 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pasadena, CA
O20170526001376 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9133031933 Receives reassigned benefits from 10 practitioners
Practice locations: Pasadena, CA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Shriners Hospitals Children49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shriners Hospitals for ChildrenPhiladelphia, PA, CCN 393309 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 24, 1966
Jun 24, 1966
Shriners Hospitals for ChildrenPortland, OR, CCN 383300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 15, 1966
Jan 15, 2015
Shriners Hospitals for ChildrenGalveston, TX, CCN 453311 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 20, 1966
Mar 20, 1966
Shriners Hospitals for ChildrenHonolulu, HI, CCN 123301 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2013
Oct 1, 2013
Shriners Hospitals for ChildrenSacramento, CA, CCN 053311 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Apr 15, 1997
Apr 15, 1997
Shriners Hospitals for ChildrenGreenville, SC, CCN 423300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 20, 2013
Jul 15, 2010
Shriners Children's OhioDayton, OH, CCN 363308 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 19, 1968
Feb 19, 1968
Shriners Hospitals for ChildrenChicago, IL, CCN 143302 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 1966
Shriners Hospitals for ChildrenSaint Louis, MO, CCN 263304 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 1966

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1972934008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500",
            "address_2": "P. O. BOX #7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "213-388-3151",
            "fax_number": "213-387-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052625",
            "telephone_number": "213-388-3151",
            "fax_number": "213-387-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRINERS HOSPITALS FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "GANTT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT, SHRINERS HOSPITALS FOR",
        "authorized_official_telephone_number": "813-281-0300"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shriners for Children Rehabilitation Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.