Organization Active NPI

Great Strides Rehabilitation Inc.

  • Specialist
  • Middleburg, FL
National Provider Identifier
1790456242
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GREAT STRIDES REHABILITATION INC.
Doing business as
Great Strides Rehabilitation Inc
Practice address
430 College Dr Ste 107
Middleburg, FL 32068-8531
Phone
(904) 886-3228
Fax
(904) 404-7743
NPI assigned
Sep 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Authorized official

Name
Amanda Streeter
Title
Vice President
Phone
(904) 944-4063

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Clinic/Center 261Q00000X

Addresses

Primary practice location

430 College Dr Ste 107
Middleburg, FL 32068-8531

Mailing address

PO Box 932184
Atlanta, GA 31193-2184
Phone (904) 886-3228

Other names 1

  • Great Strides Rehabilitation Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Great Strides Rehabilitation27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1790456242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932184",
            "telephone_number": "904-886-3228",
            "fax_number": "904-404-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 COLLEGE DR STE 107",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688531",
            "telephone_number": "904-886-3228",
            "fax_number": "904-404-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT STRIDES REHABILITATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-24",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "STREETER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "904-944-4063"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Strides Rehabilitation Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middleburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.