Envida Rehabilitation LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1939 Issued in OK

Legal business name

ENVIDA REHABILITATION LLC

Practice address

8222 E 103Rd St
Suite 127
Tulsa, OK 74133-7081

Phone

(918) 369-9100

Fax

(918) 369-9050

NPI assigned

Nov 19, 2009

Last updated

Nov 19, 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

Leon Martinez

Title

Managing Director

Phone

(918) 369-9100

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gamal H. Renteria-Lucius, RPT

  • Physical Therapist
  • Tulsa, OK
  • NPI 1245392505
  NPD (past)

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1972831550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8222 E 103RD ST",
            "address_2": "SUITE 127",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741337081",
            "telephone_number": "918-369-9100",
            "fax_number": "918-369-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8222 E 103RD ST",
            "address_2": "SUITE 127",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741337081",
            "telephone_number": "918-369-9100",
            "fax_number": "918-369-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVIDA REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LEON",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "918-369-9100"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "1939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.