Individual provider Active NPI

Sandra Huggard, PT

  • Physical Therapist
  • New Smyrna Beach, FL
National Provider Identifier
1073604005
Registry record updated Nov 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT14998 Issued in FL
Practice address
900 N Dixie Fwy
Ste 916
New Smyrna Beach, FL 32168-6220
Phone
(386) 314-3409
Fax
(866) 239-9013
NPI assigned
Sep 27, 2006
Last updated
Nov 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT14998 FL Primary

Addresses

Primary practice location

900 N Dixie Fwy
Ste 916
New Smyrna Beach, FL 32168-6220

Mailing address

900 N Dixie Fwy
Ste 916
New Smyrna Beach, FL 32168-6220
Phone (386) 314-3409

Other identifiers 1

IdentifierTypeStateIssuer
889121400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130423000130 FL Practitioner - Physical Therapist in Private Practice 0345486171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Water Therapy IncGroup PAC ID 4082850813, 3 clinicians

Practice addresses (Care Compare)

3704 Cardinal Blvd
Daytona Beach Shores, FL 32118-7301
Phone (386) 426-7885

600 Eaton Rd
Edgewater, FL 32132-3524
Phone (386) 426-7885

916 N Dixie Fwy
New Smyrna Beach, FL 32168-6220
Phone (386) 426-7885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water Therapy Inc Physical Therapist CurrentSince Feb 11, 2013 Accepting new patients

Locations

916 N Dixie Fwy
New Smyrna Beach, FL 32168
Phone (386) 426-7885

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385164800000",
    "number": "1073604005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N DIXIE FWY",
            "address_2": "STE 916",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686220",
            "telephone_number": "386-314-3409",
            "fax_number": "866-239-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N DIXIE FWY",
            "address_2": "STE 916",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686220",
            "telephone_number": "386-314-3409",
            "fax_number": "866-239-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGGARD",
        "first_name": "SANDRA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT14998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889121400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2013; 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.