Active NPI
Jack Verhees, P.T.
- Physical Therapist
- Port Orange, FL
National Provider Identifier
1013113778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT9087
- Practice address
- 4904 S Clyde Morris Blvd
Ste D2
Port Orange, FL 32129-4170 - Phone
- (386) 898-0908
- Fax
- (386) 898-0242
- NPI assigned
- Jun 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT9087 | FL | Primary |
Addresses
Primary practice location
4904 S Clyde Morris Blvd
Ste D2
Port Orange, FL 32129-4170
Mailing address
4904 S Clyde Morris Blvd
Ste D2
Port Orange, FL 32129-4170
Phone (386) 898-0908
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1869541 | Other | FL | MAIL HNADLERS GROUP |
| 5687755 | Other | FL | MAIL HANDLERSFIRST HEALTH |
| Y923L | Other | FL | BCBS FACILITY PO |
| 1720155997 | Other | FL | GROUP NPI |
| 2381853 | Other | FL | AETNA GROUP # |
| Y923D | Other | FL | BCBS FACILITY OC |
| 1196963 | Other | FL | AETNA PPO # |
| Y926B | Other | FL | BCBS FACILITY OB |
| Y0894U | Other | FL | BCBS # |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013113778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4904 S CLYDE MORRIS BLVD",
"address_2": "STE D2",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321294170",
"telephone_number": "386-898-0908",
"fax_number": "386-898-0242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4904 S CLYDE MORRIS BLVD",
"address_2": "STE D2",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321294170",
"telephone_number": "386-898-0908",
"fax_number": "386-898-0242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERHEES",
"first_name": "JACK",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT9087",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAIL HNADLERS GROUP",
"identifier": "1869541",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAIL HANDLERSFIRST HEALTH",
"identifier": "5687755",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FACILITY PO",
"identifier": "Y923L",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1720155997",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA GROUP #",
"identifier": "2381853",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FACILITY OC",
"identifier": "Y923D",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO #",
"identifier": "1196963",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FACILITY OB",
"identifier": "Y926B",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS #",
"identifier": "Y0894U",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.