Individual provider Active NPI

Rebecca Kilgore-Vohlken

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1962771477
Registry record updated Nov 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32623 Issued in FL
Practice address
12276 San Jose Blvd
Suite 508
Jacksonville, FL 32223-8628
Phone
(904) 886-3228
Fax
(904) 886-3297
NPI assigned
Dec 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-14-5808 FL
Physical Therapist 225100000X PT32623 FL Primary

Addresses

Primary practice location

12276 San Jose Blvd
Suite 508
Jacksonville, FL 32223-8628

Mailing address

12276 San Jose Blvd
Suite 508
Jacksonville, FL 32223-8628
Phone (904) 886-3228

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

LicenseStateTypeSpecialty
PT32623FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Strides Rehabilitation Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573948800000",
    "number": "1962771477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD",
            "address_2": "SUITE 508",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238628",
            "telephone_number": "904-886-3228",
            "fax_number": "904-886-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD",
            "address_2": "SUITE 508",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238628",
            "telephone_number": "904-886-3228",
            "fax_number": "904-886-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILGORE-VOHLKEN",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2019-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-14-5808",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2019; 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.