NPIMap

Organization Active NPI

Life Skill Rehab, Inc

  • Clinic/Center
  • Tarpon Springs, FL
National Provider Identifier
1356814024
Registry record updated Jan 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIFE SKILL REHAB, INC
Practice address
636 N Lake Blvd
Tarpon Springs, FL 34689-5247
Phone
(618) 599-0743
NPI assigned
Jan 5, 2019
Last updated
Jan 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2019

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

Authorized official

Name
Kynda Ray, M.S. CCC/SLPNPI 1851439467
Title
President/Owner
Phone
(618) 599-0743

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

636 N Lake Blvd
Tarpon Springs, FL 34689-5247

Mailing address

636 N Lake Blvd
Tarpon Springs, FL 34689-5247
Phone (618) 599-0743

Other identifiers 1

IdentifierTypeStateIssuer
1851439467OtherNPI

National Provider Directory

National Provider Directory

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": "1546646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547337600000",
    "number": "1356814024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 N LAKE BLVD",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346895247",
            "telephone_number": "618-599-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 N LAKE BLVD",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346895247",
            "telephone_number": "618-599-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SKILL REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-05",
        "last_updated": "2019-01-13",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "KYNDA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "618-599-0743",
        "authorized_official_credential": "M.S. CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1851439467",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2019; 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.