NPIMap

Organization Active NPI

Orlando Sports Medicine Group, Inc

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1093061673
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27565 Issued in FL
Legal business name
ORLANDO SPORTS MEDICINE GROUP, INC
Practice address
12780 Waterford Lakes Pkwy
Ste 115
Orlando, FL 32828-4500
Phone
(407) 207-7188
Fax
(407) 207-7103
NPI assigned
Aug 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Authorized official

Name
Kimary Foss
Title
Office Manager
Phone
(407) 332-7816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT27565 FL Primary

Addresses

Primary practice location

12780 Waterford Lakes Pkwy
Ste 115
Orlando, FL 32828-4500

Mailing address

12780 Waterford Lakes Pkwy
Ste 115
Orlando, FL 32828-4500
Phone (407) 207-7188

National Provider Directory

National Provider Directory
Tax ID family
Orlando Sports Medicine Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1093061673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12780 WATERFORD LAKES PKWY",
            "address_2": "STE 115",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284500",
            "telephone_number": "407-207-7188",
            "fax_number": "407-207-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12780 WATERFORD LAKES PKWY",
            "address_2": "STE 115",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284500",
            "telephone_number": "407-207-7188",
            "fax_number": "407-207-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLANDO SPORTS MEDICINE GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "FOSS",
        "authorized_official_first_name": "KIMARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-332-7816"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.