Active NPI
Corey Valentino Jones
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Clearwater, FL
National Provider Identifier
1952176745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- License
- BACB1022830
- Practice address
- 4625 E Bay Dr Ste 106
Clearwater, FL 33764-6866 - Phone
- (863) 619-2809
- NPI assigned
- Nov 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | BACB1022830 | FL | Primary |
Addresses
Primary practice location
4625 E Bay Dr Ste 106
Clearwater, FL 33764-6866
Mailing address
392 E Eufaula St
Ozark, AL 36360-0924
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BACB1022830 | FL | MD | Comprehensive Outpatient Rehabilitation Facility (CORF) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1952176745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "392 E EUFAULA ST",
"city": "OZARK",
"state": "AL",
"postal_code": "363600924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4625 E BAY DR STE 106",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337646866",
"telephone_number": "863-619-2809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "COREY",
"middle_name": "VALENTINO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-21",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "261QR0401X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
"state": "FL",
"license": "BACB1022830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.