NPIMap

Organization Active NPI

Progressive Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Ormond Beach, FL
National Provider Identifier
1013088962
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
HCC5366 Issued in FL
Legal business name
PROGRESSIVE PHYSICAL THERAPY INC
Practice address
290 Clyde Morris Blvd
Suite B-2
Ormond Beach, FL 32174-8130
Phone
(386) 898-0443
Fax
(386) 898-0459
NPI assigned
Nov 13, 2006
Last updated
Jan 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Authorized official

Name
Dr. Charles Lawrence Piazza Jr., DPT, ATC, MTC
Title
Physical Therapist, President
Phone
(386) 898-0443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X HCC5366 FL Primary

Addresses

Primary practice location

290 Clyde Morris Blvd
Suite B-2
Ormond Beach, FL 32174-8130

Mailing address

290 Clyde Morris Blvd
Suite B-2
Ormond Beach, FL 32174-8130
Phone (386) 898-0443

Other identifiers 1

IdentifierTypeStateIssuer
6457550001OtherFLPTAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1013088962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CLYDE MORRIS BLVD",
            "address_2": "SUITE B-2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748130",
            "telephone_number": "386-898-0443",
            "fax_number": "386-898-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CLYDE MORRIS BLVD",
            "address_2": "SUITE B-2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748130",
            "telephone_number": "386-898-0443",
            "fax_number": "386-898-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "PIAZZA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, PRESIDENT",
        "authorized_official_telephone_number": "386-898-0443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPT, ATC, MTC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "HCC5366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6457550001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.