NPIMap

Organization Active NPI

Prevail Therapy Services, LLC

  • Early Intervention Provider Agency
  • Ponte Vedra, FL
National Provider Identifier
1528327129
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
PREVAIL THERAPY SERVICES, LLC
Practice address
22 Bermuda Greens Ave
Ponte Vedra, FL 32081-4370
Phone
(904) 208-8811
Fax
(904) 814-8953
NPI assigned
May 16, 2012
Last updated
Mar 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Authorized official

Name
Tori S MillerNPI 1205066263
Title
Owner
Phone
(904) 208-8811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU Primary

Addresses

Primary practice location

22 Bermuda Greens Ave
Ponte Vedra, FL 32081-4370

Mailing address

22 Bermuda Greens Ave
Ponte Vedra, FL 32081-4370
Phone (904) 208-8811

National Provider Directory

National Provider Directory
Tax ID family
Prevail Therapy Services2 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.

Practitioners & affiliated clinicians

Practitioners 4

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": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1528327129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BERMUDA GREENS AVE",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320814370",
            "telephone_number": "904-208-8811",
            "fax_number": "904-814-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BERMUDA GREENS AVE",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320814370",
            "telephone_number": "904-208-8811",
            "fax_number": "904-814-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVAIL THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-16",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TORI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-208-8811"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

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