Vitalogy Rehab Services Inc.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

VITALOGY REHAB SERVICES INC.

Practice address

7550 60TH Way N
Pinellas Park, FL 33781-3216

Phone

(727) 541-4239

Fax

(727) 546-9351

NPI assigned

Jun 14, 2021

Organization subpart

No

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

Authorized official

Name

Shawn Allen Fourman, LNHA

Title

Administrator

Phone

(727) 541-4239

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1194393413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 60TH WAY N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813216",
            "telephone_number": "727-541-4239",
            "fax_number": "727-546-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 60TH WAY N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813216",
            "telephone_number": "727-541-4239",
            "fax_number": "727-546-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALOGY REHAB SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "FOURMAN",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-541-4239",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Pinellas Park, FL
• Providers in Pinellas Park, 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 Jun 14, 2021; 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.