NPIMap

Organization Active NPI

Optimum Rehabilitation Specialists, Inc

  • Multi-Specialty Clinic/Center
  • Lehigh Acres, FL
National Provider Identifier
1104327717
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
OPTIMUM REHABILITATION SPECIALISTS, INC
Practice address
2724 5TH St W Ste a
Lehigh Acres, FL 33971-1574
Phone
(239) 470-3578
NPI assigned
Feb 28, 2018
Last updated
Feb 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Authorized official

Name
Dr. Rudolph Mickey Jones, PT DPTNPI 1982873493
Title
Ceo
Phone
(239) 694-9102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

2724 5TH St W Ste a
Lehigh Acres, FL 33971-1574

Mailing address

5326 Billings St
Lehigh Acres, FL 33971-6572
Phone (239) 470-3578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104327717. Details of each certification follow.

  • CCN 686674 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 686674

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
OPTIMUM REHABILITATION SPECIALISTS INC
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jan 2, 2003
Last certification
Feb 19, 2020
Ownership / control type
Proprietary
Facility address
2724 5TH St W, Ste a
Lehigh Acres, FL 33971

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1104327717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5326 BILLINGS ST",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339716572",
            "telephone_number": "239-470-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 5TH ST W STE A",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711574",
            "telephone_number": "239-470-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM REHABILITATION SPECIALISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "RUDOLPH",
        "authorized_official_middle_name": "MICKEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-694-9102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT DPT"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

Verify at the official NPI Registry.