Interventional Rehabilitation Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1061 Issued in FL

Legal business name

INTERVENTIONAL REHABILITATION CENTER, LLC

Doing business as

Pensacola Children's Surgery Center

Practice address

1549 Airport Blvd
Ste 420
Pensacola, FL 32504-8633

Phone

(850) 484-8800

Fax

(850) 484-6020

NPI assigned

May 23, 2005

Last updated

Mar 16, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Devin Larsen

Title

Ceo

Phone

(208) 340-1840

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Pensacola Children's Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205839487. Details of each certification follow.

• CCN 10C0001294 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 10C0001294

Legal name

INTERVENTIONAL REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Feb 16, 1998

Last certification

Feb 24, 2021

Ownership / control type

Proprietary

Facility address

1549 Airport Blvd
Pensacola, FL 32504

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Ruben Berrocal Timmons, MD

  • Interventional Pain Medicine Physician
  • Gulf Breeze, FL
  • NPI 1376546572
  NPD
• Buffi G Bailey, ARNP

  • Primary Care Nurse Practitioner
  • Pensacola, FL
  • NPI 1427677756
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1205839487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 LAKESIDE BLVD STE 350",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773811216",
            "telephone_number": "713-489-2198",
            "fax_number": "713-489-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1549 AIRPORT BLVD",
            "address_2": "STE 420",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048633",
            "telephone_number": "850-484-8800",
            "fax_number": "850-484-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-340-1840"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1061",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126892800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pensacola Children's Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Intensive Care Consortium Inc
• Interim Healthcare of NW FL Inc
• Internal Medicine Associates of Pensacola, PA
• Interventional Anesthesia LLC
• Interventional Radiology Consultants, LLC
• Interventional Therapeutics Institute, LLC (Clearway Surgery Center)
• Intricate Minds, LLC
• Introcell LLC
• Anthony Paul Inzillo, PT
• Sebastian Irby

• Ambulatory Surgical Clinic/Center in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.