NPIMap

Organization Active NPI

Cora Health Services Inc.

Doing business as CORA Physical Therapy - Riverside

  • Rehabilitation Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1346516887
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
CORA HEALTH SERVICES INC.
Doing business as
CORA Physical Therapy - Riverside
Practice address
1045 Riverside Ave Ste 190
Jacksonville, FL 32204-4189
Phone
(419) 221-6717
Fax
(419) 222-0507
NPI assigned
Mar 29, 2012
Last updated
Sep 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Mr. Stephen Krzyminski
Title
Executive Vice President
Phone
(419) 221-6717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

1045 Riverside Ave Ste 190
Jacksonville, FL 32204-4189

Mailing address

PO Box 150
Lima, OH 45802-0150
Phone (419) 221-6717

Other identifiers 1

IdentifierTypeStateIssuer
X1DOtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • CORA Physical Therapy - Riverside Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051026000774 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 1759290992 17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Orange Park, FL
O20201028001048 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 1759290992 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Neptune Beach, FL

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1346516887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458020150",
            "telephone_number": "419-221-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 RIVERSIDE AVE STE 190",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044189",
            "telephone_number": "419-221-6717",
            "fax_number": "419-222-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORA HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "KRZYMINSKI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "419-221-6717",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X1D",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - Riverside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.