NPIMap

Organization Active NPI

Womens Manual Physical Therapy LLC

  • Physical Therapist
  • Crestview, FL
National Provider Identifier
1013221894
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
WOMENS MANUAL PHYSICAL THERAPY LLC
Practice address
728 N Ferdon Blvd
Ste #3
Crestview, FL 32536-2166
Phone
(850) 682-7772
Fax
(888) 308-1539
NPI assigned
Aug 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Eric Eldon DouglassNPI 1265490049
Title
Chief Clinical Officer
Phone
(239) 947-4184

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

728 N Ferdon Blvd
Ste #3
Crestview, FL 32536-2166

Mailing address

PO Box 632673
Cincinnati, OH 45263-2673
Phone (702) 818-5000

Other practice location 1

4554 E Highway 20
Niceville, FL 32578-9755
Phone (850) 897-7772

Other names 1

  • FYZICAL Therapy and Balance Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150904000776 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2365566767 Receives reassigned benefits from 8 practitioners
Practice locations: Crestview, FL; Niceville, FL

National Provider Directory

National Provider Directory

Locations

602 S Main St
Crestview, FL 32536
Phone (850) 682-7772

321 N Main St
Crestview, FL 32536
Phone (850) 682-7772

728 N Ferdon Blvd
Ste 3
Crestview, FL 32536
Phone (850) 682-7772

1846 US Highway 90 W
Ste B
Defuniak Springs, FL 32433
Phone (850) 419-5061

760 Baldwin Ave
Ste B
Defuniak Springs, FL 32435
Phone (850) 892-7772

1030 US Highway 331 S
Ste C
Defuniak Springs, FL 32435
Phone (850) 892-7772

41 Fairpoint Dr
Ste G
Gulf Breeze, FL 32561
Phone (850) 549-8728

4554 E Highway 20
Ste B
Niceville, FL 32578
Phone (850) 897-7772

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1013221894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632673",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632673",
            "telephone_number": "702-818-5000",
            "fax_number": "702-818-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N FERDON BLVD",
            "address_2": "STE #3",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325362166",
            "telephone_number": "850-682-7772",
            "fax_number": "888-308-1539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4554 E Highway 20",
            "address_purpose": "LOCATION",
            "city": "Niceville",
            "state": "FL",
            "postal_code": "325789755",
            "country_code": "US",
            "telephone_number": "850-897-7772",
            "fax_number": "888-308-1539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WOMENS MANUAL PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ELDON",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "239-947-4184"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL Therapy and Balance Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.