Organization Active NPI

Movement Driven Performance Physiotherapy

  • Physical Therapy Clinic/Center
  • St Augustine, FL
National Provider Identifier
1114679040
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MOVEMENT DRIVEN PERFORMANCE PHYSIOTHERAPY
Practice address
44 Sparrow Song PL
St Augustine, FL 32095-7590
Phone
(786) 201-3825
NPI assigned
Jan 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Authorized official

Name
Gregory Goldberger, PT, DPTNPI 1548630064
Title
Owner, PT
Phone
(786) 201-3825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

44 Sparrow Song PL
St Augustine, FL 32095-7590

Mailing address

44 Sparrow Song PL
St Augustine, FL 32095-7590
Phone (786) 201-3825

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1114679040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 SPARROW SONG PL",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320957590",
            "telephone_number": "786-201-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 SPARROW SONG PL",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320957590",
            "telephone_number": "786-201-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOVEMENT DRIVEN PERFORMANCE PHYSIOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "GOLDBERGER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER, PT",
        "authorized_official_telephone_number": "786-201-3825",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.