NPIMap

Organization Active NPI

Functional Performance

  • Physical Therapy Clinic/Center
  • Lakewood Ranch, FL
National Provider Identifier
1124474135
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
L16000080985 Issued in FL
Legal business name
FUNCTIONAL PERFORMANCE
Practice address
12630 Rockrose GLN
Lakewood Ranch, FL 34202-2829
Phone
(301) 904-2343
NPI assigned
May 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Authorized official

Name
Adam CecilNPI 1184971251
Title
Physical Therapist
Phone
(571) 338-7002

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 L16000080985 FL Primary

Addresses

Primary practice location

12630 Rockrose GLN
Lakewood Ranch, FL 34202-2829

Mailing address

12630 Rockrose GLN
Lakewood Ranch, FL 34202-2829
Phone (301) 904-2343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180320002068 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7618239252 Receives reassigned benefits from 5 practitioners
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Locations

7310 Tara Preserve Ln
Bradenton, FL 34203
Phone (301) 904-2343

5027 Ringwood Mdw
Sarasota, FL 34235
Phone (301) 904-2343

Practitioners & affiliated clinicians

Practitioners 6

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": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1124474135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12630 ROCKROSE GLN",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342022829",
            "telephone_number": "301-904-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 ROCKROSE GLN",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342022829",
            "telephone_number": "301-904-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "CECIL",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "571-338-7002"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "L16000080985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.