NPIMap

Organization Active NPI

West Coast Spine Restoration Center, Inc

  • Physical Therapist
  • Riverside, CA
National Provider Identifier
1992887616
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
WEST COAST SPINE RESTORATION CENTER, INC
Practice address
6177 River Crest Dr.
#A
Riverside, CA 92507
Phone
(951) 653-4480
Fax
(951) 653-5051
NPI assigned
Oct 20, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Nancy Kishino, OTNPI 1598847279
Title
Director
Phone
(951) 653-4480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X CA
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Hand Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251H1200X CA
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

6177 River Crest Dr.
#A
Riverside, CA 92507

Mailing address

6177 River Crest Dr.
#A
Riverside, CA 92507
Phone (951) 653-4480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301001265 CA Part B Supplier - Clinic/Group Practice 7214824648 Receives reassigned benefits from 35 practitioners
Practice locations: Riverside, CA

National Provider Directory

National Provider Directory

Locations

6177 River Crest Dr
Riverside, CA 92507
Phone (951) 653-4480

6177 River Crest Dr
Ste A
Riverside, CA 92507
Phone (951) 653-4480

Practitioners & affiliated clinicians

Practitioners 73

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 73

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1992887616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR.",
            "address_2": "#A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92507",
            "telephone_number": "951-653-4480",
            "fax_number": "951-653-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR.",
            "address_2": "#A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92507",
            "telephone_number": "951-653-4480",
            "fax_number": "951-653-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST SPINE RESTORATION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KISHINO",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "951-653-4480",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.