NPIMap

Organization Active NPI

St Mark Village Inc

Doing business as Village Health and Rehabilitation

  • Physical Therapy Clinic/Center
  • Palm Harbor, FL
National Provider Identifier
1033619846
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ST MARK VILLAGE INC
Doing business as
Village Health and Rehabilitation
Practice address
2655 Nebraska Ave
Palm Harbor, FL 34684-2630
Phone
(727) 785-2577
Fax
(727) 464-1785
NPI assigned
Feb 19, 2018
Last updated
Feb 19, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ST MARK VILLAGE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Authorized official

Name
Cynthia Pohl, MBA
Title
Chief Financial Officer
Phone
(727) 785-2577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

2655 Nebraska Ave
Palm Harbor, FL 34684-2630

Mailing address

2655 Nebraska Ave
Palm Harbor, FL 34684-2630
Phone (727) 785-2577

Other names 1

  • Village Health and Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180531000029 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7618035304 Practice locations: Palm Harbor, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033619846. Details of each certification follow.

  • CCN 686966 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 686966

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
VILLAGE HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Apr 9, 2019
Last certification
May 9, 2022
Ownership / control type
Voluntary Non-Profit Other Than Church
Facility address
2655 Nebraska Ave
Palm Harbor, FL 34684

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Part of
St Mark Village Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1033619846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 NEBRASKA AVE",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346842630",
            "telephone_number": "727-785-2577",
            "fax_number": "727-464-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 NEBRASKA AVE",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346842630",
            "telephone_number": "727-785-2577",
            "fax_number": "727-464-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARK VILLAGE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST MARK VILLAGE INC",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A",
        "authorized_official_last_name": "POHL",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "727-785-2577",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.