Active NPI
Vanessa Dirani, PT
- Physical Therapist
- Orange Park, FL
National Provider Identifier
1104906577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT31802
- Practice address
- 540 Kingsley Ave
Orange Park, FL 32073 - Phone
- (904) 264-2156
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- 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 | PT31802 | FL | Primary |
Addresses
Primary practice location
540 Kingsley Ave
Orange Park, FL 32073
Mailing address
19 Willow Falls TRL
Ponte Vedra, FL 32081-4401
Phone (904) 236-3799
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 889169900 | Medicaid | FL |
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 |
|---|---|---|---|
| PT31802 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528329600000",
"number": "1104906577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 WILLOW FALLS TRL",
"city": "PONTE VEDRA",
"state": "FL",
"postal_code": "320814401",
"telephone_number": "904-236-3799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 KINGSLEY AVE",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "32073",
"telephone_number": "904-264-2156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIRANI",
"first_name": "VANESSA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2018-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT31802",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "889169900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.