1. Home
  2. Directory
  3. Arizona
  4. Phoenix
  5. Chiropractor
  6. NPI Profile

SOUTH MOUNTAIN REHABILITATION P.C.
NPI 1124176342
Chiropractor in Phoenix, AZ

Active since January 05, 2007
4804 E CHANDLER BLVD, 106, PHOENIX, AZ 85048(480) 893-6020(480) 785-5161 Get Directions Write a Review

NPPES record last updated: January 3, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About South Mountain Rehabilitation P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH MOUNTAIN REHABILITATION P.C. (NPI 1124176342) is a healthcare organization registered as a chiropractor in Phoenix, Arizona and active in the NPI registry since January 2007. The organization lists Peter Vincent Pakulis, President, as its authorized official.

NPPES Registry Identity

NPI1124176342
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameSOUTH MOUNTAIN REHABILITATION P.C.
Location Address4804 E CHANDLER BLVD, 106Phoenix, AZ 85048-0857
Mailing Address16016 S 45th PlPhoenix, AZ 85048-7635 · (480) 759-1082 · Fax (480) 785-5161
Phone(480) 893-6020
Fax(480) 785-5161
Organization SubpartNo
Authorized OfficialPeter Vincent PakulisPresident · (480) 759-1082
Enumeration DateJanuary 5, 2007
Last NPPES UpdateJanuary 3, 2008
✔ NPI 1124176342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in AZ · 5302
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Also ListedPhysical TherapistTaxonomy 225100000X · License 2853 (AZ)
4804 E CHANDLER BLVD, Phoenix, AZ 85048
Open in Google Maps ↗

Other Identifiers 4

Medicare UPINU47087AZ
Medicare ID-Type UnspecifiedZ67951AZ · Medicare Chiropractic #
OtherAZ0295410AZ · Bcbs Physical Therapy #
OtherAZ0241550AZ · Bcbs Chiropractic #

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Mountain Rehabilitation P.C.'s NPI number?

The NPI number for South Mountain Rehabilitation P.C. is 1124176342. It was assigned to this organization in the NPPES registry on January 5, 2007.

Where is South Mountain Rehabilitation P.C. located?

South Mountain Rehabilitation P.C. is located at 4804 E Chandler Blvd 106, Phoenix, AZ 85048. The listed phone number is (480) 893-6020.

What is South Mountain Rehabilitation P.C.'s specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for South Mountain Rehabilitation P.C. was last updated on January 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.