Active NPI
John Pavicic, PT, DPT
- Physical Therapist
- N Royalton, OH
National Provider Identifier
1043845530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT017892
- Practice address
- 5340 Royalton Rd
N Royalton, OH 44133-4008 - Phone
- (440) 230-1133
- Fax
- (440) 230-9243
- NPI assigned
- Mar 5, 2020
- 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 | PT017892 | OH | Primary |
Addresses
Primary practice location
5340 Royalton Rd
N Royalton, OH 44133-4008
Mailing address
5340 Royalton Rd
N Royalton, OH 44133-4008
Phone (440) 230-1133
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 |
|---|---|---|---|
| PT017892 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583366400000",
"number": "1043845530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5340 ROYALTON RD",
"city": "N ROYALTON",
"state": "OH",
"postal_code": "441334008",
"telephone_number": "440-230-1133",
"fax_number": "440-230-9243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5340 ROYALTON RD",
"city": "N ROYALTON",
"state": "OH",
"postal_code": "441334008",
"telephone_number": "440-230-1133",
"fax_number": "440-230-9243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVICIC",
"first_name": "JOHN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-05",
"last_updated": "2020-03-05",
"certification_date": "2020-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT017892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in N Royalton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.