Organization Active NPI

Coconut Creek Rehab LLC

  • Skilled Nursing Facility
  • Coconut Creek, FL
National Provider Identifier
1093024317
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COCONUT CREEK REHAB LLC
Practice address
4125 W Sample Rd
Coconut Creek, FL 33073-4456
Phone
(954) 968-8333
Fax
(954) 968-6898
NPI assigned
Oct 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Authorized official

Name
John E Warren
Title
MGR
Phone
(954) 968-8333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X FL Primary

Addresses

Primary practice location

4125 W Sample Rd
Coconut Creek, FL 33073-4456

Mailing address

4125 W Sample Rd
Coconut Creek, FL 33073-4456
Phone (954) 968-8333

Other names 1

  • The Health Center of Coconut Creek Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315785600000",
    "number": "1093024317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 W SAMPLE RD",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734456",
            "telephone_number": "954-968-8333",
            "fax_number": "954-968-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 W SAMPLE RD",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734456",
            "telephone_number": "954-968-8333",
            "fax_number": "954-968-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COCONUT CREEK REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-04",
        "last_updated": "2011-09-12",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "954-968-8333"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Health Center of Coconut Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.