Active NPI
Timothy Crenshaw
- Physical Therapy Assistant
- Palm Coast, FL
National Provider Identifier
1114264835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3863
- Practice address
- 25 Pine Cone Dr
Palm Coast, FL 32164-8423 - Phone
- (800) 796-0923
- NPI assigned
- Jan 15, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 3863 | MS | Primary |
Addresses
Primary practice location
25 Pine Cone Dr
Palm Coast, FL 32164-8423
Mailing address
8877 Winter CT
Mobile, AL 36695-5305
Phone (251) 377-9175
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358208000000",
"number": "1114264835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8877 WINTER CT",
"city": "MOBILE",
"state": "AL",
"postal_code": "366955305",
"telephone_number": "251-377-9175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 PINE CONE DR",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321648423",
"telephone_number": "800-796-0923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRENSHAW",
"first_name": "TIMOTHY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-15",
"last_updated": "2013-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MS",
"license": "3863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.