Organization Active NPI

Advanced Rehabilitation Medical Services

  • Physical Medicine & Rehabilitation Physician
  • Port Charlotte, FL
National Provider Identifier
1174520910
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME0066000 Issued in FL
Legal business name
ADVANCED REHABILITATION MEDICAL SERVICES
Practice address
4265 Laura St
Port Charlotte, FL 33980-2836
Phone
(941) 764-7117
Fax
(941) 764-1049
NPI assigned
Jul 7, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Keith Anthony Williams, M.D.NPI 1689865891
Title
President
Phone
(941) 764-7117

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
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X ME0066000 FL Primary

Addresses

Primary practice location

4265 Laura St
Port Charlotte, FL 33980-2836

Mailing address

PO Box 510816
Punta Gorda, FL 33951-0816
Phone (941) 764-7117

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": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174520910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510816",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339510816",
            "telephone_number": "941-764-7117",
            "fax_number": "941-764-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4265 LAURA ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339802836",
            "telephone_number": "941-764-7117",
            "fax_number": "941-764-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED REHABILITATION MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-764-7117",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME0066000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.