Organization Active NPI

Natural Health Sports Therapy Inc

  • Physical Therapy Clinic/Center
  • Costa Mesa, CA
National Provider Identifier
1982930392
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NATURAL HEALTH SPORTS THERAPY INC
Practice address
1784 Newport Blvd
Costa Mesa, CA 92627-2756
Phone
(949) 645-4086
Fax
(949) 645-2014
NPI assigned
Oct 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Authorized official

Name
Mr. Mark Roche, PTA
Title
Pta
Phone
(949) 645-4086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1784 Newport Blvd
Costa Mesa, CA 92627-2756

Mailing address

1784 Newport Blvd
Costa Mesa, CA 92627-2756
Phone (949) 645-4086

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190730000647 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4688900699 Receives reassigned benefits from 2 practitioners
Practice locations: Costa Mesa, CA

National Provider Directory

National Provider Directory

Locations

1784 Newport Blvd
Costa Mesa, CA 92627
Phone (949) 546-4086

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1982930392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1784 NEWPORT BLVD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272756",
            "telephone_number": "949-645-4086",
            "fax_number": "949-645-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1784 NEWPORT BLVD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272756",
            "telephone_number": "949-645-4086",
            "fax_number": "949-645-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATURAL HEALTH SPORTS THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "ROCHE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PTA",
        "authorized_official_telephone_number": "949-645-4086",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.