The Kidz Club- St Pete,LLC

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

2929960060 Issued in FL

Legal business name

THE KIDZ CLUB- ST PETE,LLC

Doing business as

The Kidz Club

Practice address

1101 Herr LN
Louisville, KY 40222-4301

Phone

(502) 210-5538

Fax

(502) 327-5098

NPI assigned

Dec 21, 2012

Organization subpart

No

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

Authorized official

Name

Debbie A Hunt

Title

VP of Operations

Phone

(502) 458-5433

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Kidz Club Doing business as

Tax ID family

The Kidz Club2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• The Kidz Club- St Pete, LLC

  dba The Kidz Club- St. Pete

  • Pediatric Skilled Nursing Facility
  • St Petersburg, FL
  • NPI 1932495702
  NPD tax ID

Locations

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

{
    "created_epoch": "1356048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356048000000",
    "number": "1356687222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 3RD AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014033",
            "telephone_number": "727-821-5439",
            "fax_number": "727-821-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HERR LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224301",
            "telephone_number": "502-210-5538",
            "fax_number": "502-327-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KIDZ CLUB- ST PETE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-21",
        "last_updated": "2012-12-21",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "502-458-5433"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "FL",
            "license": "2929960060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003967601",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kidz Club",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Hearts Program LLC
• The Home of the Innocents
• The Home of the Innocents, Inc.
• The House
• The Innerview, PLLC
• The Lasik Vision Institute, LLC
• The Louisville Bone & Joint Center
• The Louisville Dental Studio
• The Medi Sell Corp (Electro Med Systems)
• The Middle Way, LLC

• Pediatric Skilled Nursing Facility in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Skilled Nursing Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; 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.