Pain and Spine Physio Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT7862 Issued in FL

Legal business name

PAIN AND SPINE PHYSIO REHAB LLC

Practice address

100 Southpark Blvd
Suite 408 B
St Augustine, FL 32086-5189

Phone

(518) 407-3422

NPI assigned

Oct 29, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Regino Irwin B Reyes, PTNPI 1861448557

Title

Ambr

Phone

(518) 407-3422

Specialties & licenses 2

Addresses

Locations

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.

• Regino Irwin Bariso Reyes, PT

  • Physical Therapist
  • St Augustine, FL
  • NPI 1861448557
  Authorized official Same address or phone

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1073918371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SOUTHPARK BLVD",
            "address_2": "SUITE 408-B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865189",
            "telephone_number": "518-407-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTHPARK BLVD",
            "address_2": "SUITE 408 B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865189",
            "telephone_number": "518-407-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN AND SPINE PHYSIO REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "REGINO IRWIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "AMBR",
        "authorized_official_telephone_number": "518-407-3422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT7862",
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "FL",
            "license": "PT0007862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Elizabeth Pacetti, ARNP
• Swarna L Pachigalla, RPH
• Enma Linda Padilla-Lynch
• Pamela Marie Padilla, M.D.
• Brittany Paglicco
• Pain Management Specialists of North Florida P a
• Pain Solutions & Physical Therapy, Inc.
• Rex Beasom Painter, DDS
• Gezim Pajaziti, APRN
• Bruce Henry Paley, D.O.

• Physical Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.