Organization Active NPI

Recovery Institute of the South East P.a.

  • Multi-Specialty Clinic/Center
  • Fort Lauderdale, FL
National Provider Identifier
1881014405
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RECOVERY INSTITUTE OF THE SOUTH EAST P.A.
Practice address
915 Middle River Dr Ste 201
Ft Lauderdale, FL 33304-3559
Phone
(800) 723-9788
Fax
(800) 723-9788
NPI assigned
Apr 22, 2014
Last updated
Jan 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Bet Shaddinger, LMFTNPI 1497029573
Title
Ceo, Owner, Administrator
Phone
(800) 723-9788

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

915 Middle River Dr Ste 201
Ft Lauderdale, FL 33304-3559

Mailing address

915 Middle River Dr Ste 201
Ft Lauderdale, FL 33304-3559
Phone (800) 723-9788

Other identifiers 2

IdentifierTypeStateIssuer
382147100MedicaidFL
017837600MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@rise-therapeuticservices.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240905000036 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6901346998 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

915 Middle River Dr
Ste 201
Ft Lauderdale, FL 33304
Phone (800) 723-9788

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1881014405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 MIDDLE RIVER DR STE 201",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043559",
            "telephone_number": "800-723-9788",
            "fax_number": "800-723-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MIDDLE RIVER DR STE 201",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043559",
            "telephone_number": "800-723-9788",
            "fax_number": "800-723-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY INSTITUTE OF THE SOUTH EAST P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-22",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "SHADDINGER",
        "authorized_official_first_name": "BET",
        "authorized_official_title_or_position": "CEO, OWNER, ADMINISTRATOR",
        "authorized_official_telephone_number": "800-723-9788",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382147100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017837600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@rise-therapeuticservices.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "915 Middle River Dr Ste 201",
            "city": "Ft Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333043559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.