Superhero Kids Ppec, LLC.

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

Legal business name

SUPERHERO KIDS PPEC, LLC.

Practice address

1700 W Woolbright Rd Ste 3
Boynton Beach, FL 33426-6346

Phone

(561) 877-2152

Fax

(561) 810-4197

NPI assigned

Jan 27, 2022

Last updated

Jan 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelsey Allen

Title

Owner Administrator

Phone

(561) 877-2152

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1851044168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W WOOLBRIGHT RD STE 3",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266346",
            "telephone_number": "561-877-2152",
            "fax_number": "561-810-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W WOOLBRIGHT RD STE 3",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266346",
            "telephone_number": "561-877-2152",
            "fax_number": "561-810-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERHERO KIDS PPEC, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "561-877-2152"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA PPEC LICENSE",
            "identifier": "60081108",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.