NPIMap

Organization Active NPI

First Coast Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • St Augustine, FL
National Provider Identifier
1003823709
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
18156 Issued in FL
Legal business name
FIRST COAST PHYSICAL THERAPY INC
Practice address
2630 US 1 S
St Augustine, FL 32086-6191
Phone
(904) 829-3411
NPI assigned
Aug 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Authorized official

Name
Bryan Olson, PTNPI 1124367073
Title
Owner
Phone
(904) 829-3411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 18156 FL Primary

Addresses

Primary practice location

2630 US 1 S
St Augustine, FL 32086-6191

Mailing address

2630 US 1 S
St Augustine, FL 32086-6191
Phone (904) 829-3411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070501000021 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9436255973 Receives reassigned benefits from 16 practitioners
Practice locations: St Augustine, FL
O20250925003234 FL DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 9436255973 Practice locations: St Augustine, FL

National Provider Directory

National Provider Directory

Locations

2630 US Highway 1 S
St Augustine, FL 32086
Phone (904) 829-3411

209 Blackford Way
Ste A
St Augustine, FL 32086
Phone (904) 907-1122

1 University Blvd
St Augustine, FL 32086
Phone (904) 826-0084

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753401600000",
    "number": "1003823709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 US 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866191",
            "telephone_number": "904-829-3411",
            "fax_number": "904-829-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 US 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866191",
            "telephone_number": "904-829-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-829-3411",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "18156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.