Sustainable Rehabilitation LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

SUSTAINABLE REHABILITATION LLC

Practice address

17 Lakeside PL W
Palm Coast, FL 32137-3415

Phone

(775) 343-9322

NPI assigned

Jun 14, 2024

Organization subpart

No

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

Authorized official

Name

Marca Alexander, MD

Title

Owner

Phone

(775) 343-9322

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1962245274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LAKESIDE PL W",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373415",
            "telephone_number": "775-343-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LAKESIDE PL W",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373415",
            "telephone_number": "775-343-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSTAINABLE REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "MARCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-343-9322",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.