NPIMap

Organization Active NPI

Cora Health Services Inc

Doing business as CORA Physical Therapy - Westside

  • Rehabilitation Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1003849654
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
CORA HEALTH SERVICES INC
Doing business as
CORA Physical Therapy - Westside
CORA Rehabilitation Clinics - Westside
Practice address
6248 103Rd Street
Jacksonville, FL 32210-7733
Phone
(904) 573-0046
Fax
(904) 573-0772
NPI assigned
Jul 8, 2006
Last updated
Oct 19, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CORA HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Authorized official

Name
Mr. Stephen Krzyminski
Title
Executive Vice President
Phone
(419) 221-6717

Specialties & licenses 1

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

Addresses

Primary practice location

6248 103Rd Street
Jacksonville, FL 32210-7733

Mailing address

PO Box 150
Lima, OH 45802-0150
Phone (419) 221-6717

Other names 2

  • CORA Physical Therapy - Westside Doing business as
  • CORA Rehabilitation Clinics - Westside Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051026000774 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 1759290992 17 other NPIs on this enrollment
Practice locations: Jacksonville, FL; Orange Park, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003849654. Details of each certification follow.

  • CCN 686722 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 686722

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CORA PHYSICAL THERAPY- WESTSIDE
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Mar 30, 2004
Last certification
Apr 14, 2017
Ownership / control type
Proprietary
Facility address
6248 103Rd St
Jacksonville, FL 32210

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Cora Health117 organizations share this tax ID, including this one
Part of
Cora Health

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1003849654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458020150",
            "telephone_number": "419-221-6717",
            "fax_number": "419-222-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6248 103RD STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107733",
            "telephone_number": "904-573-0046",
            "fax_number": "904-573-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORA HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORA HEALTH SERVICES INC",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "KRZYMINSKI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "419-221-6717",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - Westside",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CORA Rehabilitation Clinics - Westside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.