Active NPI
Nancy Barafon Ilagan, PT
- Physical Therapist
- Brooksville, FL
National Provider Identifier
1083865760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT10736
- Practice address
- 11535 Cortez Blvd
Brooksville, FL 34613-7373 - Phone
- (352) 592-0010
- Fax
- (352) 592-0011
- NPI assigned
- Oct 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT10736 | FL | Primary |
Addresses
Primary practice location
11535 Cortez Blvd
Brooksville, FL 34613-7373
Mailing address
11535 Cortez Blvd
Brooksville, FL 34613-7373
Phone (352) 592-0010
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 686593 | Other | FL | MEDICARE |
| 759013000 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT10736 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab Kinetics Inc | Multi-Specialty | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222819200000",
"number": "1083865760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11535 CORTEZ BLVD",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346137373",
"telephone_number": "352-592-0010",
"fax_number": "352-592-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11535 CORTEZ BLVD",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346137373",
"telephone_number": "352-592-0010",
"fax_number": "352-592-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARAFON ILAGAN",
"first_name": "NANCY",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-01",
"last_updated": "2008-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT10736",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "686593",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "759013000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooksville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.