Pasco C.O.R.F., Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PASCO C.O.R.F., INC.

Doing business as

Pasco Rehabilitation

Practice address

37104 Clinton Ave
Dade City, FL 33525-5911

Phone

(352) 521-0002

Fax

(352) 521-5958

NPI assigned

Jan 24, 2008

Last updated

Nov 20, 2009By 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

Mrs. Deborah A Knickerbocker

Title

Administrator

Phone

(352) 521-0002

Specialties & licenses 1

Addresses

Other names 1

• Pasco Rehabilitation Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942487640. Details of each certification follow.

• CCN 106763 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 106763

Legal name

PASCO REHABILITATION

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jun 10, 1991

Last certification

Jun 9, 2022

Ownership / control type

Proprietary

Facility address

37104 Clinton Ave
Dade City, FL 33525

Locations

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1942487640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37104 CLINTON AVE",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255911",
            "telephone_number": "352-521-0002",
            "fax_number": "352-521-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37104 CLINTON AVE",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255911",
            "telephone_number": "352-521-0002",
            "fax_number": "352-521-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASCO C.O.R.F., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "KNICKERBOCKER",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-521-0002",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pasco Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Palm Medical Center Lakeland LLC
• Palm Medical Centers
• Iraisy Paneque, PHARMD
• Abhishek Parnerkar
• Kelly Young Partain, OTR,L
• Pasco Caregivers LLC
• Pasco Emergency Physicians LLC
• Pasco Hernando Hma Physician Management, LLC
• Pasco Hma Inc (Pasco Regional Medical Center)
• Pasco Imaging Consultants

• Physical Therapy Clinic/Center in Dade City, FL
• Providers in Dade City, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.