NPIMap

Organization Active NPI

Kinetic Rehab Solutions, LLC

  • Occupational Therapist
  • Jacksonville, FL
National Provider Identifier
1821397365
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT12624 Issued in FL
Legal business name
KINETIC REHAB SOLUTIONS, LLC
Practice address
12615 Brady Place Blvd
Jacksonville, FL 32223-2590
Phone
(904) 755-1311
Fax
(904) 239-5984
NPI assigned
Mar 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Authorized official

Name
Laura Vernon Smith, OTR/L/MOTNPI 1194904359
Title
Administrator
Phone
(904) 755-1311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT12624 FL Primary

Addresses

Primary practice location

12615 Brady Place Blvd
Jacksonville, FL 32223-2590

Mailing address

12615 Brady Place Blvd
Jacksonville, FL 32223-2590
Phone (904) 755-1311

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1821397365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12615 BRADY PLACE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232590",
            "telephone_number": "904-755-1311",
            "fax_number": "904-239-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 BRADY PLACE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232590",
            "telephone_number": "904-755-1311",
            "fax_number": "904-239-5984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC REHAB SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-23",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "VERNON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-755-1311",
        "authorized_official_credential": "OTR/L/MOT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT12624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.