Individual provider Active NPI

Jodi Dyer, PT

  • Physical Therapist
  • Pensacola, FL
National Provider Identifier
1003868001
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
38215 Issued in FL
Practice address
10040 Hillview Dr
Pensacola, FL 32514-5499
Phone
(910) 818-4240
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 38215 FL Primary

Addresses

Primary practice location

10040 Hillview Dr
Pensacola, FL 32514-5499

Mailing address

112 Crystal PT
Sanford, NC 27332-6642
Phone (910) 423-5550

Other identifiers 4

IdentifierTypeStateIssuer
187071OtherNCMEDCOST
079YFOtherNCBLUE CROSS BLUE SHIELD NC
125357800OtherNCUS DEPART OF LABOR
501889202OtherNCTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250407001682 FL Practitioner - Physical Therapist in Private Practice 3678580578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, 600 clinicians

Practice addresses (Care Compare)

10780 N US Hwy 301
Oxford, FL 34484-3505
Phone 3523303900658

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38215FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jan 28, 2025 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Apr 1, 2025 Accepting new patients
Legacy Healthcare Services, Inc Physical Therapist CurrentSince Jan 28, 2025 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Apr 1, 2025 Accepting new patients
Advanced Physical Therapy Solutions LLC Physical Therapist PastSince Jun 1, 2004 Accepting new patients

Locations

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

2100 10th Ave
Vero Beach, FL 32960
Phone (772) 365-4539

910 Regency Sq
Vero Beach, FL 32967
Phone (772) 213-0423

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1003868001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CRYSTAL PT",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273326642",
            "telephone_number": "910-423-5550",
            "fax_number": "910-423-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10040 HILLVIEW DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145499",
            "telephone_number": "910-818-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "JODI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "38215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "187071",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "079YF",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPART OF LABOR",
            "identifier": "125357800",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "501889202",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.