Individual provider Active NPI

Jayna Dinsmore, L.M.T., P.T.A

  • Physical Therapy Assistant
  • Lakeland, FL
National Provider Identifier
1003289570
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 26011 Issued in FL
Practice address
321 Imperial Blvd
D38
Lakeland, FL 33803
Phone
(186) 093-0294
NPI assigned
Nov 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 26011 FL Primary
Physical Therapy Assistant 225200000X 1564 CT
Massage Therapist 225700000X MA79747 FL
Massage Therapist 225700000X 1315 CT

Addresses

Primary practice location

321 Imperial Blvd
D38
Lakeland, FL 33803

Mailing address

321 Imperial Blvd
D38
Lakeland, FL 33803-5622
Phone (860) 930-2948

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
PTA 26011FLMDPhysical Therapy Assistant
MA79747FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1003289570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 IMPERIAL BLVD",
            "address_2": "D38",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338035622",
            "telephone_number": "860-930-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 IMPERIAL BLVD",
            "address_2": "D38",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33803",
            "telephone_number": "186-093-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINSMORE",
        "first_name": "JAYNA",
        "credential": "L.M.T., P.T.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 26011",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "1564",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA79747",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CT",
            "license": "1315",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.