NPIMap

Organization Active NPI

Full Spectrum Rehabilitation and Wellness, LLC

  • Occupational Therapist
  • Ithaca, NY
National Provider Identifier
1508407768
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
FULL SPECTRUM REHABILITATION AND WELLNESS, LLC
Practice address
15 Catherwood Rd
Ithaca, NY 14850-1071
Phone
(607) 227-4421
Fax
(607) 463-0602
NPI assigned
Sep 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Rebecca L Fisher, MS, OTR/LNPI 1912230301
Title
Occupational Therapist/Owner
Phone
(607) 227-4421

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 3

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

Addresses

Primary practice location

15 Catherwood Rd
Ithaca, NY 14850-1071

Mailing address

96 Gunderman Rd
Ithaca, NY 14850-8624
Phone (607) 227-4421

Other practice location 1

840 Hanshaw Rd Ste 4
Ithaca, NY 14850-1589
Phone (607) 227-4421

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Hellonote Health Information Exchange (HIE)
Other URL WebPT Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

840 Hanshaw Rd
Ste 4
Ithaca, NY 14850
Phone (607) 227-4421

15 Catherwood Rd
Ithaca, NY 14850
Phone (607) 227-4421

Practitioners & affiliated clinicians

Practitioners 8

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": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1508407768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 GUNDERMAN RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148508624",
            "telephone_number": "607-227-4421",
            "fax_number": "607-463-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CATHERWOOD RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501071",
            "telephone_number": "607-227-4421",
            "fax_number": "607-463-0602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 Hanshaw Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148501589",
            "country_code": "US",
            "telephone_number": "607-227-4421",
            "fax_number": "607-463-0602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FULL SPECTRUM REHABILITATION AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-30",
        "last_updated": "2022-08-10",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "607-227-4421",
        "authorized_official_credential": "MS, OTR/L"
    },
    "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": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Hellonote",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15 Catherwood Rd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148501071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WebPT",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "840 Hanshaw Rd Ste 4",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148501589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.