NPIMap

Organization Active NPI

Rehab Engineering LLC

  • Prosthetic/Orthotic Supplier
  • Tallahassee, FL
National Provider Identifier
1194972158
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
POR28 Issued in FL
Legal business name
REHAB ENGINEERING LLC
Practice address
1719 Mahan Dr
Tallahassee, FL 32308-5201
Phone
(850) 656-3599
Fax
(850) 656-6483
NPI assigned
Aug 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Authorized official

Name
Jeffrey Ryan Fredrick, CPO
Title
Owner
Phone
(850) 656-3599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X POR28 FL Primary

Addresses

Primary practice location

1719 Mahan Dr
Tallahassee, FL 32308-5201

Mailing address

1719 Mahan Dr
Tallahassee, FL 32308-5201
Phone (850) 656-3599

Other identifiers 1

IdentifierTypeStateIssuer
032561900MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140910002227 FL DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 3173727427 Practice locations: Tallahassee, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Rehab Engineering LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

311 N Dawson St
Thomasville, GA 31792
Phone (229) 226-4114

2225 Bemiss Rd
Valdosta, GA 31602
Phone (229) 241-2005

NPI Registry JSON

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

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1194972158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 MAHAN DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085201",
            "telephone_number": "850-656-3599",
            "fax_number": "850-656-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 MAHAN DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085201",
            "telephone_number": "850-656-3599",
            "fax_number": "850-656-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB ENGINEERING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-21",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "FREDRICK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-656-3599",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "POR28",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032561900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.