Active NPI
Rehab Resource
- Occupational Therapist
- Radcliff, KY
National Provider Identifier
1457594491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- R3688
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 186645 | Other | KY | MEDICAIRE ID |
| 7100051110 | Medicaid | KY |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Physical Therapist
- Radcliff, KY
- NPI 1811005572
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.