Provision Rehab Inc

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT6210 Issued in FL

Legal business name

PROVISION REHAB INC

Practice address

3610 Old Lighthouse Cir
Wellington, FL 33414-8843

Phone

(561) 352-4939

Fax

(561) 333-0994

NPI assigned

Feb 2, 2012

Organization subpart

No

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

Authorized official

Name

Judith A Brown-Ray, OTR/L

Title

Pres

Phone

(561) 352-4939

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1922370261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 OLD LIGHTHOUSE CIR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148843",
            "telephone_number": "561-352-4939",
            "fax_number": "561-333-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 OLD LIGHTHOUSE CIR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148843",
            "telephone_number": "561-352-4939",
            "fax_number": "561-333-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "BROWN-RAY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "561-352-4939",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT6210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Wellington, FL
• Providers in Wellington, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.