Individual provider Active NPI

Timoth Dench, PHYSICAL THERAPIST

  • Physical Therapist
  • Winter Haven, FL
National Provider Identifier
1104897768
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00724500 Issued in NJ
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, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
40QA00724500NJMDPhysical 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.

Verify at the official NPI Registry.