NPIMap

Organization Active NPI

RWW Senior Living Outpatient Rehab Services, LLC

  • Physical Therapist
  • St Johns, FL
National Provider Identifier
1093553240
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RWW SENIOR LIVING OUTPATIENT REHAB SERVICES, LLC
Practice address
2430 County Road 21 W
St Johns, FL 32259
Phone
(904) 717-7782
NPI assigned
Jul 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Angie Mattingly
Title
MGR Provider Enrollment
Phone
(502) 394-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2430 County Road 21 W
St Johns, FL 32259

Mailing address

805 N Whittington Pkwy Ste 400
Louisville, KY 40222-7102

National Provider Directory

National Provider Directory
Tax ID family
RWW Senior Living Outpatient Rehab Services LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1093553240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N WHITTINGTON PKWY STE 400",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402227102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 COUNTY ROAD 21 W",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "32259",
            "telephone_number": "904-717-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RWW SENIOR LIVING OUTPATIENT REHAB SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "MATTINGLY",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "MGR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "502-394-2100"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.