Organization Active NPI

NRV Enterprises Inc

Doing business as Functional Rehab Center

  • Physical Therapy Clinic/Center
  • Sebring, FL
National Provider Identifier
1518990753
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
106953 Issued in FL
Legal business name
NRV ENTERPRISES INC
Doing business as
Functional Rehab Center
Practice address
4141 Sun N Lake Blvd
Sebring, FL 33872-2131
Phone
(863) 385-6119
Fax
(863) 385-9698
NPI assigned
Jul 9, 2006
Last updated
Oct 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Authorized official

Name
Mr. Roy G. Asumbrado, RPT
Title
Administrator
Phone
(863) 385-6119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 106953 FL Primary

Addresses

Primary practice location

4141 Sun N Lake Blvd
Sebring, FL 33872-2131

Mailing address

4141 Sun N Lake Blvd
Sebring, FL 33872-2131
Phone (863) 385-6119

Other identifiers 2

IdentifierTypeStateIssuer
R8BOtherFLBCBSF
883844500MedicaidFL

Other names 1

  • FUNCTIONAL REHAB CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060221000250 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 6800801382 1 other NPI on this enrollment
Practice locations: Sebring, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Functional Rehab Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1518990753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722131",
            "telephone_number": "863-385-6119",
            "fax_number": "863-385-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722131",
            "telephone_number": "863-385-6119",
            "fax_number": "863-385-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NRV ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "ASUMBRADO",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "863-385-6119",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "106953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSF",
            "identifier": "R8B",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "883844500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FUNCTIONAL REHAB CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.