Organization Active NPI

Brooks Rehabilitation

  • Occupational Therapist
  • Orange Park, FL
National Provider Identifier
1013425073
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
18830 Issued in FL
Legal business name
BROOKS REHABILITATION
Practice address
500 Park Ave
Orange Park, FL 32073-3132
Phone
(904) 278-7890
NPI assigned
Jan 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Authorized official

Name
Olivia Dicks, OTR/L
Title
Occupational Therapist
Phone
(904) 278-7890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 18830 FL Primary

Addresses

Primary practice location

500 Park Ave
Orange Park, FL 32073-3132

Mailing address

3901 University Blvd S
Jacksonville, FL 32216-4312

Other names 1

  • Brooks Rehab Former legal business name

National Provider Directory

National Provider Directory

Locations

500 Park Ave
Orange Park, FL 32073
Phone (904) 278-7890

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1013425073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733132",
            "telephone_number": "904-278-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKS REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "DICKS",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "904-278-7890",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "18830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brooks Rehab",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.