Individual provider Active NPI

Evan Todd Bitner, PTA

  • Physical Therapy Assistant
  • Sanford, FL
National Provider Identifier
1073765392
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 21265 Issued in FL
Practice address
1200 Lexington Green Lane
Sanford, FL 32771
Phone
(407) 332-3442
NPI assigned
Oct 17, 2008
Last updated
Oct 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 21265 FL Primary

Addresses

Primary practice location

1200 Lexington Green Lane
Sanford, FL 32771

Mailing address

18107 Thornhill Grand Circle
Orlando, FL 32820-2733
Phone (407) 568-6020

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

LicenseStateTypeSpecialty
PTA 21265FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1073765392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18107 THORNHILL GRAND CIRCLE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328202733",
            "telephone_number": "407-568-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LEXINGTON GREEN LANE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "32771",
            "telephone_number": "407-332-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BITNER",
        "first_name": "EVAN",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-17",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 21265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; 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.