NPIMap

Organization Active NPI

Innovative Therapies Group Inc

  • Occupational Therapist
  • Lady Lake, FL
National Provider Identifier
1174768360
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 4267 Issued in FL
Legal business name
INNOVATIVE THERAPIES GROUP INC
Practice address
929 Hwy 27/441
Unit 301
Lady Lake, FL 32159-3002
Phone
(352) 433-0091
Fax
(352) 433-0676
NPI assigned
Dec 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Authorized official

Name
Ms. Kimberly A Lancaster, OTR/LNPI 1629213459
Title
President
Phone
(352) 216-1911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT 00330 FL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT 4267 FL Primary
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X OT 4267 FL
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SA 2999 FL

Addresses

Primary practice location

929 Hwy 27/441
Unit 301
Lady Lake, FL 32159-3002

Mailing address

929 Hwy 27/441
Unit 301
Lady Lake, FL 32159-3002
Phone (352) 433-0091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090330000331 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2769549104 Receives reassigned benefits from 6 practitioners
Practice locations: Lady Lake, FL; Ocala, FL; Summerfield, FL; Wildwood, FL
O20140108000257 FL DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 2769549104 Practice locations: Lady Lake, FL

National Provider Directory

National Provider Directory
Tax ID family
Innovative Therapies Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

804 Highway 466
Lady Lake, FL 32159
Phone (352) 267-9170

929 N US Highway 27/441
Ste 301
Lady Lake, FL 32159

2801 SW College Rd
Ste 5
Ocala, FL 34474
Phone (352) 433-0091

2801 SW College Rd
Ste 1112
Ocala, FL 34474

2801 SW College Rd
Ste 51112
Ocala, FL 34474

2801 SW College Rd
Ste 11
Ocala, FL 34474
Phone (352) 433-0091

837 S Main St
Wildwood, FL 34785
Phone (352) 750-6387

805 S Main St
Wildwood, FL 34785
Phone (352) 433-0091

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1174768360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 HWY 27/441",
            "address_2": "UNIT 301",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593002",
            "telephone_number": "352-433-0091",
            "fax_number": "352-433-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 HWY 27/441",
            "address_2": "UNIT 301",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593002",
            "telephone_number": "352-433-0091",
            "fax_number": "352-433-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE THERAPIES GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-02",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "LANCASTER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-216-1911",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 00330",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 4267",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "FL",
            "license": "OT 4267",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 2999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.