Organization Active NPI

Knee Rejuvenation Group of Florida

  • Physical Medicine & Rehabilitation Physician
  • Pensacola, FL
National Provider Identifier
1104546241
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
KNEE REJUVENATION GROUP OF FLORIDA
Practice address
2114 Airport Blvd Ste 1500
Pensacola, FL 32504-5910
Phone
(850) 979-5633
NPI assigned
Aug 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Authorized official

Name
Stephen Krause
Title
Owner
Phone
(850) 979-5633

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X
Multi-Specialty Clinic/Center 261QM1300X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

2114 Airport Blvd Ste 1500
Pensacola, FL 32504-5910

Mailing address

2114 Airport Blvd Ste 1500
Pensacola, FL 32504-5910
Phone (850) 979-5633

National Provider Directory

National Provider Directory

Locations

2114 Airport Blvd
Ste 1500
Pensacola, FL 32504
Phone (850) 969-2340

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1104546241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 AIRPORT BLVD STE 1500",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045910",
            "telephone_number": "850-979-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 AIRPORT BLVD STE 1500",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045910",
            "telephone_number": "850-979-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNEE REJUVENATION GROUP OF FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "KRAUSE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-979-5633"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.