Individual provider Active NPI

Jamal King

  • Physical Therapy Assistant
  • Bradenton, FL
National Provider Identifier
1134095920
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA29758 Issued in FL
Practice address
2105 Manatee Ave E FL 34208
Bradenton, FL 34208-1640
Phone
(941) 745-7394
NPI assigned
Oct 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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 PTA29758 FL Primary

Addresses

Primary practice location

2105 Manatee Ave E FL 34208
Bradenton, FL 34208-1640

Mailing address

3813 Helene St
Sarasota, FL 34233-1109
Phone (570) 687-4867

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
PTA29758FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1134095920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3813 HELENE ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331109",
            "telephone_number": "570-687-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 MANATEE AVE E FL 34208",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081640",
            "telephone_number": "941-745-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JAMAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.