Integrated Rehab. PA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4421 Issued in FL

Legal business name

INTEGRATED REHAB. PA

Practice address

2180 SW 115TH Ter
Davie, FL 33325-4854

Phone

(954) 816-1029

Fax

(954) 577-3444

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Mark Niles, PT, MS, CSCS

Title

Owner

Phone

(954) 816-1029

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1649380411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 SW 115TH TER",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333254854",
            "telephone_number": "954-816-1029",
            "fax_number": "954-577-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 SW 115TH TER",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333254854",
            "telephone_number": "954-816-1029",
            "fax_number": "954-577-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REHAB. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "NILES",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-816-1029",
        "authorized_official_credential": "PT, MS, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "4421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Davie, FL
• Providers in Davie, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.