NPIMap

Organization Active NPI

Genesis Rehabilitation Services

  • Speech-Language Pathologist
  • Hudson, FL
National Provider Identifier
1215247333
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA2502 Issued in FL
Legal business name
GENESIS REHABILITATION SERVICES
Practice address
7927 State Road 52
Hudson, FL 34667-6783
Phone
(727) 378-8586
Fax
(727) 378-8587
NPI assigned
Oct 8, 2010
Last updated
Oct 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Authorized official

Name
Mrs. Susan Gayle Mardjetko, MSCCCSLPNPI 1659688869
Title
Speech Language Pathologist
Phone
(727) 378-8586

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
Speech-Language Pathologist 235Z00000X SA2502 FL Primary

Addresses

Primary practice location

7927 State Road 52
Hudson, FL 34667-6783

Mailing address

7927 State Road 52
Hudson, FL 34667-6783
Phone (727) 378-8586

National Provider Directory

National Provider Directory
Tax ID family
Genesis Eldercare Rehab LLC209 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Practitioners & affiliated clinicians

Practitioners 1

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": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1215247333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7927 STATE ROAD 52",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346676783",
            "telephone_number": "727-378-8586",
            "fax_number": "727-378-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7927 STATE ROAD 52",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346676783",
            "telephone_number": "727-378-8586",
            "fax_number": "727-378-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "MARDJETKO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "GAYLE",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "727-378-8586",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSCCCSLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA2502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.