NPIMap

Organization Active NPI

Ultima Rehab-FL LLC

  • Geriatric Physical Therapist
  • North Fort Myers, FL
National Provider Identifier
1053970194
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
Legal business name
ULTIMA REHAB-FL LLC
Practice address
390 Pondella Rd Ste 9
North Fort Myers, FL 33903-4340
Phone
(609) 509-2388
NPI assigned
Jun 12, 2019
Last updated
Jun 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Authorized official

Name
Richard Austin Duus
Title
Cfo
Phone
(609) 509-2388

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251G0304X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

390 Pondella Rd Ste 9
North Fort Myers, FL 33903-4340

Mailing address

132 Pearlcroft Rd
Cherry Hill, NJ 08034-3334
Phone (609) 509-2388

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 190

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.

View all 190

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1053970194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 PEARLCROFT RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343334",
            "telephone_number": "609-509-2388",
            "fax_number": "267-790-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 PONDELLA RD STE 9",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339034340",
            "telephone_number": "609-509-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMA REHAB-FL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "DUUS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "609-509-2388"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.