Organization Active NPI

Ablehearts Rehabilitation, LLC

  • Occupational Therapist
  • Hazel Crest, IL
National Provider Identifier
1114706637
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
ABLEHEARTS REHABILITATION, LLC
Practice address
17400 Kedzie Ave
Hazel Crest, IL 60429-1600
Phone
(618) 780-3256
NPI assigned
Sep 25, 2023
Last updated
Sep 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Authorized official

Name
Risty Smith, OTR/L, CHC
Title
President
Phone
(813) 285-2802

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

17400 Kedzie Ave
Hazel Crest, IL 60429-1600

Mailing address

4042 Park Oaks Blvd Ste 300
Tampa, FL 33610-9539
Phone (813) 635-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240110003758 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3971954298 Receives reassigned benefits from 6 practitioners
Practice locations: Hazel Crest, IL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1114706637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4042 PARK OAKS BLVD STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336109539",
            "telephone_number": "813-635-9500",
            "fax_number": "732-285-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 KEDZIE AVE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291600",
            "telephone_number": "618-780-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABLEHEARTS REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RISTY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-285-2802",
        "authorized_official_credential": "OTR/L, CHC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.