Active NPI
Alicia Bornemann, PT, DPT
- Physical Therapist
- Winter Haven, FL
National Provider Identifier
1114524675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT36307
- Practice address
- 5535 Cypress Gardens Blvd Ste 260
Winter Haven, FL 33884-2241 - Phone
- (863) 877-0605
- NPI assigned
- Oct 7, 2020
- Sex
- Female
- 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 Therapist | 225100000X | PT36307 | FL | Primary |
Addresses
Primary practice location
5535 Cypress Gardens Blvd Ste 260
Winter Haven, FL 33884-2241
Mailing address
5535 Cypress Gardens Blvd Ste 260
Winter Haven, FL 33884-2241
Phone (863) 877-0605
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT36307 | FL | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
Interoperability endpoints
- alicia.bornemann.1@27269.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681430400000",
"number": "1114524675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5535 CYPRESS GARDENS BLVD STE 260",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338842241",
"telephone_number": "863-877-0605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5535 CYPRESS GARDENS BLVD STE 260",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338842241",
"telephone_number": "863-877-0605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORNEMANN",
"first_name": "ALICIA",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-07",
"last_updated": "2023-04-14",
"certification_date": "2023-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT36307",
"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 Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.