NPIMap

Organization Active NPI

Prescribed Pediatric Extended Care, Inc

  • Physical Therapist
  • Daytona Beach, FL
National Provider Identifier
1861074726
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRESCRIBED PEDIATRIC EXTENDED CARE, INC
Practice address
125 Executive Cir
Daytona Beach, FL 32114-1180
Phone
(386) 253-6868
NPI assigned
Apr 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Heidi Tosti
Title
VP Finance
Phone
(813) 880-0320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

125 Executive Cir
Daytona Beach, FL 32114-1180

Mailing address

8509 Benjamin Rd Ste D
Tampa, FL 33634-1224
Phone (813) 769-5358

Other identifiers 1

IdentifierTypeStateIssuer
880567903MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Health Choice33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

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": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1861074726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8509 BENJAMIN RD STE D",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336341224",
            "telephone_number": "813-769-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 EXECUTIVE CIR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141180",
            "telephone_number": "386-253-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCRIBED PEDIATRIC EXTENDED CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "TOSTI",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "813-880-0320"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880567903",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.