NPIMap

Organization Active NPI

Integrated Physical Therapy Services of North Florida, LLC

Doing business as Balanced Therapy and Wellness

  • Physical Medicine & Rehabilitation Physician
  • Lakewood Ranch, FL
National Provider Identifier
1093183519
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
INTEGRATED PHYSICAL THERAPY SERVICES OF NORTH FLORIDA, LLC
Doing business as
Balanced Therapy and Wellness
Practice address
7230 University Pkwy
Lakewood Ranch, FL 34240-8330
Phone
(904) 412-2882
NPI assigned
Sep 15, 2015
Last updated
Jun 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Authorized official

Name
Gregory Richard Carr, DPTNPI 1114018116
Title
Ceo
Phone
(904) 412-2882

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

7230 University Pkwy
Lakewood Ranch, FL 34240-8330

Mailing address

3948 3Rd St S # 133
Jacksonville Beach, FL 32250-5847
Phone (904) 412-2882

Other practice location 1

5939 Roosevelt Blvd
Jacksonville, FL 32244-2356
Phone (904) 412-2882

Other names 1

  • BALANCED THERAPY AND WELLNESS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170516001032 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9830476118 Receives reassigned benefits from 8 practitioners
Practice locations: Lakewood Ranch, FL

National Provider Directory

National Provider Directory
Tax ID family
Balanced Therapy and Wellness2 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.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1093183519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 3RD ST S # 133",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505847",
            "telephone_number": "904-412-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7230 UNIVERSITY PKWY",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342408330",
            "telephone_number": "904-412-2882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5939 Roosevelt Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322442356",
            "country_code": "US",
            "telephone_number": "904-412-2882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED PHYSICAL THERAPY SERVICES OF NORTH FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-412-2882",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BALANCED THERAPY AND WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.