Individual provider Active NPI

Scott Ronald Maycroft

  • Physical Therapy Assistant
  • Englewood, FL
National Provider Identifier
1114298593
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA12631 Issued in FL
Practice address
1111 Drury LN
Englewood, FL 34224-4545
Phone
(941) 473-7132
Fax
(941) 473-7136
NPI assigned
Jan 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA12631 FL Primary

Addresses

Primary practice location

1111 Drury LN
Englewood, FL 34224-4545

Mailing address

1111 Drury LN
Englewood, FL 34224-4545
Phone (941) 473-7132

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
PTA12631FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1114298593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DRURY LN",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342244545",
            "telephone_number": "941-473-7132",
            "fax_number": "941-473-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DRURY LN",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342244545",
            "telephone_number": "941-473-7132",
            "fax_number": "941-473-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYCROFT",
        "first_name": "SCOTT",
        "middle_name": "RONALD",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA12631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.