Lighthouse Pilates & Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LIGHTHOUSE PILATES & PHYSICAL THERAPY, LLC

Practice address

4435 Sheridan St
Hollywood, FL 33021-3513

Phone

(954) 391-8823

NPI assigned

Jan 5, 2022

Organization subpart

No

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

Authorized official

Name

Mary Ebanks-Nunaihed, DPTNPI 1326314360

Title

Owner/Manager

Phone

(954) 391-8823

Specialties & licenses 1

Addresses

Other names 1

• Lighthouse Pilates, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Mary E. Ebanks-Nunaihed, DPT

  • Physical Therapist
  • Hollywood, FL
  • NPI 1326314360
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1801557541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 POLK ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216615",
            "telephone_number": "954-699-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213513",
            "telephone_number": "954-391-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PILATES & PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "EBANKS-NUNAIHED",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "954-391-8823",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Pilates, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Lighthouse Pilates, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.