Active NPI
Timoth Dench, PHYSICAL THERAPIST
- Physical Therapist
- Winter Haven, FL
National Provider Identifier
1104897768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00724500
- Practice address
- 950 1St St S
Suite 202
Winter Haven, FL 33880-3665 - Phone
- (863) 293-7778
- Fax
- (863) 299-3836
- NPI assigned
- Jan 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 40QA00724500 | NJ | Primary |
Addresses
Primary practice location
950 1St St S
Suite 202
Winter Haven, FL 33880-3665
Mailing address
16413 Bridgelawn Ave
Lithia, FL 33547-4849
Phone (813) 829-9009
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 |
|---|---|---|---|
| 40QA00724500 | NJ | MD | Physical Therapist |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104897768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16413 BRIDGELAWN AVE",
"city": "LITHIA",
"state": "FL",
"postal_code": "335474849",
"telephone_number": "813-829-9009",
"fax_number": "863-299-3836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 1ST ST S",
"address_2": "SUITE 202",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338803665",
"telephone_number": "863-293-7778",
"fax_number": "863-299-3836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENCH",
"first_name": "TIMOTH",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00724500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.