Individual provider Active NPI

Christopher Nicolosi, PTA

  • Physical Therapy Assistant
  • Ocala, FL
National Provider Identifier
1093848822
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA20179 Issued in FL
Practice address
2135 SW 19TH Avenue Rd Suite 103
2135 SW 19TH Avenue Rd Ste 103
Ocala, FL 34471-7877
Phone
(352) 368-1340
Fax
(352) 237-7728
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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 PTA20179 FL Primary

Addresses

Primary practice location

2135 SW 19TH Avenue Rd Suite 103
2135 SW 19TH Avenue Rd Ste 103
Ocala, FL 34471-7877

Mailing address

2230 SW 19TH Avenue Rd
Ocala, FL 34471-1391
Phone (352) 237-4133

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
PTA20179FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ocala Family Medical Center, Inc. CurrentSince Jul 28, 2024 Accepting new patients
Solace Anesthesia, LLC PastSince Jul 28, 2024 Accepting new patients
TLC Rehab, LLC Past Accepting new patients

Locations

2135 SW 19th Avenue Rd
Ste 103
Ocala, FL 34471
Phone (352) 237-4133

2230 SW 19th Avenue Rd
Ocala, FL 34471
Phone (352) 237-4133

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1093848822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 SW 19TH AVENUE RD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344711391",
            "telephone_number": "352-237-4133",
            "fax_number": "352-237-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 SW 19TH AVENUE RD SUITE 103",
            "address_2": "2135 SW 19TH AVENUE RD STE 103",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344717877",
            "telephone_number": "352-368-1340",
            "fax_number": "352-237-7728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLOSI",
        "first_name": "CHRISTOPHER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA20179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.