Individual provider Active NPI

Jody Rochelle Martin, MSPT

  • Physical Therapist
  • Port St Lucie, FL
National Provider Identifier
1063723583
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 23976 Issued in FL
Practice address
1867 SW Jamesport Dr
Port St Lucie, FL 34953-4599
Phone
(917) 892-5187
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 23976 FL Primary
Physical Therapist 225100000X 6402 AZ
Physical Therapist 225100000X 30329 CA
Physical Therapist 225100000X 025997-1 NY

Addresses

Primary practice location

1867 SW Jamesport Dr
Port St Lucie, FL 34953-4599

Mailing address

1867 SW Jamesport Dr
Port St Lucie, FL 34953-4599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130410000048 FL Practitioner - Physical Therapist in Private Practice 4082850433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Palm City, FL 34990
Phone (772) 444-7754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 23976FLMDPhysical Therapist
025997-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin in Motion Therapy Services LLC Physical Therapist CurrentSince Jul 1, 2021 Accepting new patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Apr 8, 2022 Accepting new patients
Florida Movement Therapy Center-Boca Raton, LLC Physical Therapist PastSince Dec 3, 2012 Accepting new patients

Locations

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1063723583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 SW JAMESPORT DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 SW JAMESPORT DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534599",
            "telephone_number": "917-892-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JODY",
        "middle_name": "ROCHELLE",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 23976",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6402",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "30329",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025997-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.