Individual provider Active NPI

Joshua Timmons, PTA

  • Physical Therapy Assistant
  • Lake City, FL
National Provider Identifier
1013559731
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
29813 Issued in FL
Practice address
945 SW Main Blvd
Lake City, FL 32025-5746
Phone
(386) 755-3164
Fax
(386) 755-3165
NPI assigned
Oct 14, 2019
Last updated
Oct 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 29813 FL Primary

Addresses

Primary practice location

945 SW Main Blvd
Lake City, FL 32025-5746

Mailing address

945 SW Main Blvd
Lake City, FL 32025-5746
Phone (386) 755-3164

Other practice location 1

5080 Newberry Rd Ste 2A
Gainesville, FL 32607-2251
Phone (352) 325-2276

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29813FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Motion Therapy of Lake City LLC CurrentSince Nov 1, 2019 Accepting new patients
Pro Motion Therapy of Lake City LLC CurrentSince Jan 10, 2008 Accepting new patients

Locations

5080 Newberry Rd
#2A
Gainesville, FL 32607
Phone (352) 325-2276

945 SW Main Blvd
Lake City, FL 32025
Phone (386) 755-3164

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1013559731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255746",
            "telephone_number": "386-755-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255746",
            "telephone_number": "386-755-3164",
            "fax_number": "386-755-3165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5080 Newberry Rd Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326072251",
            "country_code": "US",
            "telephone_number": "352-325-2276",
            "fax_number": "352-877-4580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "JOSHUA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "29813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.