Suncrest Outpatient Rehab Services, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SUNCREST OUTPATIENT REHAB SERVICES, LLC

Doing business as

SunCrest Rehab Services

Practice address

1503 Oak St
Jacksonville, FL 32204-3910

Phone

(904) 353-2019

Fax

(904) 353-7762

NPI assigned

May 23, 2008

Last updated

Jun 29, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda McFaddin

Title

Director of Licensing/Accreditation

Phone

(615) 712-2250

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SunCrest Rehab Services Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Suncrest Home Health of Georgia, Inc.

  dba Adoration Home Health

  • Home Health Agency
  • Covington, GA
  • NPI 1770882300

  Member Of

  NPD member

Locations

Practitioners 3

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.

• Autumn H O'Neal, SLP

  • Speech-Language Pathologist
  • Macclenny, FL
  • NPI 1386954212
  NPD (past)
• Trini Rivera, OTR/L

  • Occupational Therapist
  • Jacksonville, FL
  • NPI 1932404795
  NPD (past)
• Elizabeth Sanz, OTR/L

  • Occupational Therapist
  • Jacksonville, FL
  • NPI 1609185057
  NPD (past)

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1649438805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HOSPITAL DR",
            "address_2": "SUITE 150",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155033",
            "telephone_number": "615-627-9267",
            "fax_number": "615-577-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 OAK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043910",
            "telephone_number": "904-353-2019",
            "fax_number": "904-353-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCREST OUTPATIENT REHAB SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "MCFADDIN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "DIRECTOR OF LICENSING/ACCREDITATION",
        "authorized_official_telephone_number": "615-712-2250"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NO.",
            "identifier": "AS074",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NO",
            "identifier": "HCC9132",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SunCrest Rehab Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.