Genesis Rehab Services

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA11456 Issued in FL

Legal business name

GENESIS REHAB SERVICES

Practice address

552 Spanish Way W
Fernandina Beach, FL 32034-9244

Phone

(904) 310-9411

NPI assigned

Apr 29, 2013

Organization subpart

Yes

Parent organization

GENESISAs reported in NPPES

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

Authorized official

Name

Mary Ellen Mathe

Title

Cota

Phone

(904) 310-9411

Specialties & licenses 1

Addresses

Part of

Genesis Rehab Services

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1376988717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 SPANISH WAY W",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320349244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 SPANISH WAY W",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320349244",
            "telephone_number": "904-310-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS REHAB SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESIS",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "MATHE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "COTA",
        "authorized_official_telephone_number": "904-310-9411"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA11456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Gaudiana, MS
• Michael Adam Gebel, M.D.
• Mary Geffroy
• Kimberly Gayle Geib, ARNP
• Genesis Health Development, Inc.
• Pebbles Gilbert
• Emily Gilchrist, PTA
• Alexis Gill, APRN
• Jorge N Glass, MD
• Glenn N Taylor Jr DMD MD PA

• Occupational Therapy Assistant in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.