CMS-1500 Box 24J / 33a • NPI
1487174991
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
2081S0010X (CMS 23)
Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation, Sports Medicine
Box 32 Service Location & ZIP+4
18800 DELAWARE ST STE 150, HUNTINGTON BEACH, CA, 92648-6012
✓ 9-Digit EDI 837 ZIP+4 (92648-6012)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1487174991 (360 SPORTS, SPINE AND WELLNESS, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1487174991 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | 360 SPORTS, SPINE AND WELLNESS, INC. |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation, Sports Medicine NUCC Code: 2081S0010X (Physical Medicine & Rehabilitation, Sports Medicine) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 18800 DELAWARE ST STE 150, HUNTINGTON BEACH, CA, 92648-6012 |
| Practice Telephone / Fax | Tel: (714) 848-9319 |
| Administrative Mailing Address | 18800 DELAWARE ST STE 150, HUNTINGTON BEACH, CA, 92648-6012 |
| Enumeration & Last Sync | Enumerated: 2017-06-26 | CMS Record Updated: 2017-06-26 |
| Authorized Official | CHRIS MARKER (Physician) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (2081S0010X)
What Does Taxonomy Code 2081S0010X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2081S0010X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation, Sports Medicine"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (360 SPORTS, SPINE AND WELLNESS, INC.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
2081S0010X — Physical Medicine & Rehabilitation, Sports MedicinePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation, Sports Medicine | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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