Jennifer Lynn Kotlarczyk, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT21671 Issued in FL

Practice address

3030 University Pkwy
Sarasota, FL 34243-2502

Phone

(941) 359-8233

Fax

(941) 359-8255

NPI assigned

Jun 12, 2006

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 identifiers 4

Other names 1

• Jennifer Lynn Benson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Legacy Healthcare Inc

  dba Legacy Physical Therapy & Sports Training

  • Physical Therapist
  • Sarasota, FL
  • NPI 1306883962
  NPD (past)
• Legacy Healthcare Inc

  dba Legacy Physical Therapy & Sports Training

  • Physical Therapist
  • Parrish, FL
  • NPI 1710930771
  NPD (past)
• Legacy Healthcare Inc

  dba Legacy Physical Therapy & Sports Training

  • Physical Therapist
  • Venice, FL
  • NPI 1972556017
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1083656185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7216 US HIGHWAY 301 N",
            "address_2": "SUITE 115",
            "city": "ELLENTON",
            "state": "FL",
            "postal_code": "342223462",
            "telephone_number": "941-729-0003",
            "fax_number": "941-729-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 UNIVERSITY PKWY",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432502",
            "telephone_number": "941-359-8233",
            "fax_number": "941-359-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTLARCZYK",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP PROV NUMBER",
            "identifier": "2989794",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI INDIV PROV NUM",
            "identifier": "6606642",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIV PROV NUM",
            "identifier": "Y061L",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890852400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BENSON",
            "middle_name": "LYNN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• N. Mathew Koshy, M.D.
• Jenny Kosman, M.D.
• Shari Lynne Kotch, SLP
• Ashot S Kotcharian, MD
• James David Kotick, MD
• Sara Kotomski
• Leone Kotze, DDS
• Emily Joy Koudelka, HAS
• Joseph Koukl, PA-C
• Devi Koung, RPH

• Physical Therapist in Sarasota, FL
• Providers in Sarasota, 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 31, 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.