NPIMap

Organization Active NPI

Physical Therapy and Rehabiitation Clinic Inc

  • Physical Therapist
  • Macclenny, FL
National Provider Identifier
1710040159
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL THERAPY AND REHABIITATION CLINIC INC
Practice address
31 S 5TH St
Macclenny, FL 32063-2301
Phone
(904) 259-8343
Fax
(904) 272-8814
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Dan W Weldon, P.T.
Title
President
Phone
(904) 259-8343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

31 S 5TH St
Macclenny, FL 32063-2301

Mailing address

2140 Kingsley Ave
Suite 5
Orange Park, FL 32073-5180
Phone (904) 272-2830

National Provider Directory

National Provider Directory
Tax ID family
Physical Therapy Rehabilitation Clinic Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710040159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE",
            "address_2": "SUITE 5",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735180",
            "telephone_number": "904-272-2830",
            "fax_number": "904-272-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 S 5TH ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632301",
            "telephone_number": "904-259-8343",
            "fax_number": "904-272-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AND REHABIITATION CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WELDON",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-259-8343",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macclenny, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.