Denise Bush Overlock, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA9272 Issued in FL

Practice address

1601 6TH St SE
Suite B
Winter Haven, FL 33880-4605

Phone

(863) 294-0350

Fax

(863) 294-0381

NPI assigned

Nov 25, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474675200000",
    "number": "1053741256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 AVENUE H NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814353",
            "telephone_number": "863-291-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 6TH ST SE",
            "address_2": "SUITE B",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804605",
            "telephone_number": "863-294-0350",
            "fax_number": "863-294-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERLOCK",
        "first_name": "DENISE",
        "middle_name": "BUSH",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2016-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA9272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2016; 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.