Active NPI
Edward Paul Meadors Jr., DPT
- Physical Therapist
- Fort Walton Beach, FL
National Provider Identifier
1023664182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 33086
- Practice address
- 1110 Hospital Rd
Fort Walton Beach, FL 32547-6742 - Phone
- (850) 563-8129
- Fax
- (850) 314-6364
- NPI assigned
- Aug 14, 2019
- 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 | 33086 | FL | Primary |
Addresses
Primary practice location
1110 Hospital Rd
Fort Walton Beach, FL 32547-6742
Mailing address
318 Bream Ave Unit G
Fort Walton Beach, FL 32548-6125
Phone (765) 716-8328
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
| License | State | Type | Specialty |
|---|---|---|---|
| 33086 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565740800000",
"number": "1023664182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 BREAM AVE UNIT G",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325486125",
"telephone_number": "765-716-8328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 HOSPITAL RD",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476742",
"telephone_number": "850-563-8129",
"fax_number": "850-314-6364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEADORS",
"first_name": "EDWARD",
"middle_name": "PAUL",
"name_suffix": "Jr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-14",
"last_updated": "2019-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "33086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.