Organization Active NPI

Elite Rehabilitation and Pain Management LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Largo, FL
National Provider Identifier
1942724059
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
OS14566 Issued in FL
Legal business name
ELITE REHABILITATION AND PAIN MANAGEMENT LLC
Practice address
901 Clearwater Largo Rd N
Largo, FL 33770-4126
Phone
(727) 586-2999
NPI assigned
Jul 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Authorized official

Name
Stephanie Webb, DONPI 1831323732
Title
Owner
Phone
(914) 924-1494

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
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X OS14566 FL
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X OS14566 FL Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

901 Clearwater Largo Rd N
Largo, FL 33770-4126

Mailing address

1029 Roundstone PL
Palm Harbor, FL 34683-1462

Other identifiers 1

IdentifierTypeStateIssuer
R25Y9OtherFLBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180117000125 FL Part B Supplier - Clinic/Group Practice 4587923719 Receives reassigned benefits from 1 practitioner
Practice locations: Largo, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1501459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1942724059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 ROUNDSTONE PL",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CLEARWATER LARGO RD N",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337704126",
            "telephone_number": "727-586-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE REHABILITATION AND PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-31",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-924-1494",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "OS14566",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "OS14566",
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "R25Y9",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.