NPIMap

Organization Active NPI

Greatstridesrehabilitation

  • Community/Behavioral Health Agency
  • Jacksonville, FL
National Provider Identifier
1033566351
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GREATSTRIDESREHABILITATION
Practice address
12276 San Jose Blvd
Jacksonville, FL 32223-8628
Phone
(904) 886-3228
NPI assigned
May 17, 2016
Last updated
May 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Authorized official

Name
Samantha Peacock
Title
HR Manager
Phone
(904) 886-3228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

12276 San Jose Blvd
Jacksonville, FL 32223-8628

Mailing address

11276 San Jose Blvd
Jacksonville, FL 32223, FL 32233

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1033566351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11276 SAN JOSE BLVD",
            "city": "JACKSONVILLE, FL 32223",
            "state": "FL",
            "postal_code": "32233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238628",
            "telephone_number": "904-886-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATSTRIDESREHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "HR MANAGER",
        "authorized_official_telephone_number": "904-886-3228"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.