Individual provider Active NPI

Jessica Mason Hosford, P.T.

  • Physical Therapist
  • Gulf Breeze, FL
National Provider Identifier
1093967879
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24326 Issued in FL
Practice address
1515 Lighthouse CT
Gulf Breeze, FL 32563-5900
Phone
(407) 493-3815
NPI assigned
Oct 13, 2008
Last updated
Apr 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT24326 FL
Physical Therapist 225100000X 24326 FL Primary

Addresses

Primary practice location

1515 Lighthouse CT
Gulf Breeze, FL 32563-5900

Mailing address

1515 Lighthouse CT
Gulf Breeze, FL 32563-5900
Phone (407) 493-3815

Other practice location 1

4107 Teriwood Ave
Orlando, FL 32812-7980
Phone (407) 493-3815

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100726000907 FL Practitioner - Physical Therapist in Private Practice 9931232048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1183 Ceylon Dr
Gulf Breeze, FL 32563-5438
Phone (850) 512-6949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24326FLMDPhysical Therapist
PT24326FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Physical Therapist CurrentSince Feb 26, 2019 Accepting new patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients
Wave Therapy CurrentSince Mar 13, 2019 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Feb 26, 2019 Accepting new patients

Locations

1000 Fianna Way
Fort Smith, AR 72919
Phone (479) 201-6089

3530 Sandalwood Cir
Naples, FL 34109
Phone (239) 770-4367

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1093967879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 LIGHTHOUSE CT",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325635900",
            "telephone_number": "407-493-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 LIGHTHOUSE CT",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325635900",
            "telephone_number": "407-493-3815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4107 Teriwood Ave",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328127980",
            "country_code": "US",
            "telephone_number": "407-493-3815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOSFORD",
        "first_name": "JESSICA",
        "middle_name": "MASON",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT24326",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "24326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.