Andrea N Buck, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT35469 Issued in FL

Practice address

350 13TH Ave S
Jacksonville Beach, FL 32250-5024

Phone

(904) 853-5106

NPI assigned

Jul 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Andrea N Kimmet Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Coltman and Baughman Physical Therapy PA

  • Physical Therapy Clinic/Center
  • Jacksonville, FL
  • NPI 1962079467
  NPD
• Coltman and Baughman Physical Therapy PA

  • Physical Therapy Clinic/Center
  • Jacksonville Beach, FL
  • NPI 1659781300
  NPD (past)

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1053939694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 ASHCROFT LANDING DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322254179",
            "telephone_number": "757-561-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 13TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505024",
            "telephone_number": "904-853-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "ANDREA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT35469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "KIMMET",
            "middle_name": "N",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Calli Lizabeth Brubeck, RDN
• Craig Bryan III, DC
• Helen Bryan, ARNP
• Amy Bucciarelli, MS,ATR-BC, LMHC, NCC
• Julie Jabour Buchanan
• Anne Thu-Anh Bui, MD
• Hong Tu Bui, PHAMD
• Kelly M Bumgarner, PA-C
• Carl Burak, M.D.
• Ronnie Burak, PH.D.

• Physical Therapist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.