NPIMap

Organization Active NPI

Heartland Rehabilitation Services of Florida LLC

  • Rehabilitation Clinic/Center
  • Alachua, FL
National Provider Identifier
1104925429
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
HEARTLAND REHABILITATION SERVICES OF FLORIDA LLC
Practice address
15260 NW 147TH Dr
Alachua, FL 32615-5309
Phone
(386) 462-4349
Fax
(386) 418-0824
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Barry A Lazarus
Title
Vice President - Reimbursements
Phone
(419) 252-5541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

15260 NW 147TH Dr
Alachua, FL 32615-5309

Mailing address

540 Kingsley Ave
Orange Park, FL 32073-4847
Phone (904) 264-2156

Other identifiers 7

IdentifierTypeStateIssuer
028496300MedicaidFL
1617682OtherFLCIGNA
8845212-35MedicaidFL
Q1COtherFLBCBS
160630535OtherFLDEPARTMENT OF LABOR
4477946OtherFLAETNA NON-HMO
102701OtherFLAVMED

Other names 1

  • Heartland Rehabilitation Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050910000156 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3971411851 12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Palatka, FL; Mayo, FL; Live Oak, FL; Hernando, FL; Gainesville, FL; Lake City, FL; Chiefland, FL; Crystal River, FL

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

540 Kingsley Ave
Orange Park, FL 32073
Phone (904) 264-2156

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1104925429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734847",
            "telephone_number": "904-264-2156",
            "fax_number": "904-264-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15260 NW 147TH DR",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326155309",
            "telephone_number": "386-462-4349",
            "fax_number": "386-418-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND REHABILITATION SERVICES OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LAZARUS",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT - REIMBURSEMENTS",
        "authorized_official_telephone_number": "419-252-5541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028496300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1617682",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8845212-35",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Q1C",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "160630535",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "4477946",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "102701",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Rehabilitation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alachua, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.