Keystone Healthcare & Rehabilitation Services Inc

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

KEYSTONE HEALTHCARE & REHABILITATION SERVICES INC

Practice address

2040 NE Coachman Rd
Suite a
Clearwater, FL 33765-2600

Phone

(727) 796-5478

Fax

(727) 796-5635

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert Daniel Sparks

Title

Owner

Phone

(727) 796-5478

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Comprehensive outpatient rehabilitation facility certification: CCN 684825

Legal name

KEYSTONE HEALTHCARE AND REHABILITATION SERVICES IN

Certification status

Active

Provider type (POS)

Comprehensive outpatient rehabilitation facility

Participating since

Dec 5, 2002

Last certification

Sep 25, 2023

Ownership / control type

Proprietary

Facility address

2040 NE Coachman Rd
Clearwater, FL 33765

Locations

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1114077666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 NE COACHMAN RD",
            "address_2": "SUITE A",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337652600",
            "telephone_number": "727-796-5478",
            "fax_number": "727-796-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 NE COACHMAN RD",
            "address_2": "SUITE A",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337652600",
            "telephone_number": "727-796-5478",
            "fax_number": "727-796-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE HEALTHCARE & REHABILITATION SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-796-5478",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Augusta Kervin, RPH
• Sara Kesneck, M.A., CCC-SLP
• Samantha Rose Kessler, OD
• Tyler Ketcham
• Benjamin Bennett Keyes, PH.D.,ED.D.,LMHC
• KG Health Partners, Inc
• KG Medical Inc.
• Charl Khalil, MD
• Moeen Khalil, M.D.
• Deva Khalsa, VMD

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.