NPIMap

Organization Active NPI

Palm Coast Sports Medicine and Rehab

  • Occupational Therapist
  • Palm Coast, FL
National Provider Identifier
1932376555
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1549 Issued in FL
Legal business name
PALM COAST SPORTS MEDICINE AND REHAB
Practice address
35 Old Kings Rd N
Palm Coast, FL 32137-8227
Phone
(386) 445-5555
Fax
(386) 445-9800
NPI assigned
May 13, 2008
Last updated
May 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Authorized official

Name
Ms. Edith Lynn, OT
Title
Administrator
Phone
(386) 445-5555

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0010163 FL
Physical Therapist 225100000X 4154 FL
Occupational Therapist 225X00000X 1549 FL Primary
Speech-Language Pathologist 235Z00000X SA6443 FL

Addresses

Primary practice location

35 Old Kings Rd N
Palm Coast, FL 32137-8227

Mailing address

35 Old Kings Rd N
Palm Coast, FL 32137-8227
Phone (386) 445-5555

National Provider Directory

National Provider Directory
Tax ID family
Palm Coast Sports Medicine and Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

35 Old Kings Rd N
Palm Coast, FL 32137
Phone (386) 445-5555

Practitioners & affiliated clinicians

Practitioners 5

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": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1932376555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 OLD KINGS RD N",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378227",
            "telephone_number": "386-445-5555",
            "fax_number": "386-445-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 OLD KINGS RD N",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378227",
            "telephone_number": "386-445-5555",
            "fax_number": "386-445-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM COAST SPORTS MEDICINE AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "EDITH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-445-5555",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "0010163",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "4154",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "1549",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6443",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.