Jad Therapy LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

OS 0006090 Issued in FL

Legal business name

JAD THERAPY LLC

Practice address

1669 SE Highway 19
Crystal River, FL 34429

Phone

(352) 563-2407

Fax

(352) 563-2807

NPI assigned

Sep 25, 2006

Last updated

Aug 22, 2020By 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

James Arthur Derrenbacker Jr., D.O.

Title

Ceo

Phone

(352) 563-2407

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235239625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2154",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34423",
            "telephone_number": "352-563-2407",
            "fax_number": "352-563-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 SE HIGHWAY 19",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34429",
            "telephone_number": "352-563-2407",
            "fax_number": "352-563-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAD THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DERRENBACKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-563-2407",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "OS 0006090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.