Organization Active NPI

Rehab Resource

  • Occupational Therapist
  • Radcliff, KY
National Provider Identifier
1457594491
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
R3688 Issued in KY
Legal business name
REHAB RESOURCE
Practice address
111 N Woodland Dr Ste C
Radcliff, KY 40160
Phone
(270) 351-3511
Fax
(270) 351-3514
NPI assigned
Apr 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Authorized official

Name
Shigufta Qureshi
Title
Ceo
Phone
(270) 351-3511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X R3688 KY Primary

Addresses

Primary practice location

111 N Woodland Dr Ste C
Radcliff, KY 40160

Mailing address

111 N Woodland Dr Ste C
Radcliff, KY 40160-2678
Phone (270) 351-3511

Other identifiers 2

IdentifierTypeStateIssuer
186645OtherKYMEDICAIRE ID
7100051110MedicaidKY

National Provider Directory

National Provider Directory

Locations

111 N Woodland Dr
Ste C
Radcliff, KY 40160
Phone (270) 351-3511

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1457594491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WOODLAND DR STE C",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "401602678",
            "telephone_number": "270-351-3511",
            "fax_number": "270-351-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WOODLAND DR STE C",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "40160",
            "telephone_number": "270-351-3511",
            "fax_number": "270-351-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB RESOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "QURESHI",
        "authorized_official_first_name": "SHIGUFTA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-351-3511"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R3688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAIRE ID",
            "identifier": "186645",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100051110",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Radcliff, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.