Vital Rehabilitation LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT28237 Issued in FL

Legal business name

VITAL REHABILITATION LLC

Practice address

3600 Peoria Rd Ste 202203
Orange Park, FL 32065-7685

Phone

(904) 657-0089

Fax

(904) 560-5283

NPI assigned

Sep 20, 2016

Organization subpart

No

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

Authorized official

Name

Jennifer Justice, DPTNPI 1891948774

Title

Owner/Physical Therapist

Phone

(904) 434-5737

Specialties & licenses 3

Addresses

Tax ID family

Vital Rehabilitation LLC2 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.

• Vital Rehabilitation LLC.

  • Sports Physical Therapist
  • Orange Park, FL
  • NPI 1639576093
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Amanda Justice, DPT, SCS

  • Physical Therapist
  • Orange Park, FL
  • NPI 1891948774
  NPD Authorized official
• Eric Beausoleil, DPT

  • Physical Therapist
  • Fleming Island, FL
  • NPI 1942752100
  NPD (past)

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1780132662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 GREEN HERON CT",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038600",
            "telephone_number": "904-434-5737",
            "fax_number": "904-512-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 PEORIA RD STE 202203",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657685",
            "telephone_number": "904-657-0089",
            "fax_number": "904-560-5283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Virgils Way Unit 1A",
            "address_purpose": "LOCATION",
            "city": "Green Cove Springs",
            "state": "FL",
            "postal_code": "320433780",
            "country_code": "US",
            "telephone_number": "904-657-0089",
            "fax_number": "905-560-5283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VITAL REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "JUSTICE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "904-434-5737",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28237",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vision Manot, Inc
• Visionworks Inc
• Visionworks, Inc.
• Vital Health Associates of Florida LLC
• Vital Pharmacy LLC
• Vital Rehabilitation LLC.
• Sherley Edwine Vixamar
• VK Medical Group LLC
• VK Medical Group LLC
• Jossette Trinh Vo, DMD

• Physical Therapist in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.