Physical Therapy Wellness Group

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PHYSICAL THERAPY WELLNESS GROUP

Practice address

519 SW Nagle Place
Port Saint Lucie, FL 34953

Phone

(772) 209-1183

NPI assigned

Jun 7, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Sperancia Anna White, DPTNPI 1750602462

Title

Physical Therapist/Owner

Phone

(772) 209-1183

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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.

• Sperancia Anna White, DPT

  • Physical Therapist
  • Port Saint Lucie, FL
  • NPI 1750602462
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590192000000",
    "number": "1023677630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10380 SW VILLAGE CENTER DR # 355",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349871931",
            "telephone_number": "772-209-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 SW NAGLE PLACE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34953",
            "telephone_number": "772-209-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-07",
        "last_updated": "2020-05-23",
        "certification_date": "2020-05-23",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "SPERANCIA",
        "authorized_official_middle_name": "ANNA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "772-209-1183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261Q00000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix House of Hope Inc
• Phoenix Resolutions Treatment Center
• Phoenix Resolutions Treatment Facility
• Tran Phung
• Physical Therapy Connection LLC
• Physician Assistant Surgical Services, Inc.
• Edna Pierre Louis
• Carla Pilato
• Pinnacle Rehabilitation Group
• Yarianni Pino Collazo

• Clinic/Center in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2020; 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.