John Raymond Yandek

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA26802 Issued in FL

Practice address

15601 Redington Dr
Redington Beach, FL 33708-1739

Phone

(727) 512-4316

NPI assigned

Jul 15, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473033600000",
    "number": "1134572084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15601 REDINGTON DR",
            "city": "REDINGTON BEACH",
            "state": "FL",
            "postal_code": "337081739",
            "telephone_number": "727-512-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15601 REDINGTON DR",
            "city": "REDINGTON BEACH",
            "state": "FL",
            "postal_code": "337081739",
            "telephone_number": "727-512-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANDEK",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-15",
        "last_updated": "2016-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26802",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA003680",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FL - DEPARTMENT OF HEALTH",
            "identifier": "PTA26802",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA SECRETARY OF STATE",
            "identifier": "PTA003680",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theron A. Jernigan Jr., P.T.
• Sydney Nicole Leuschke, MA, CCC-SLP
• Pamela E Liedke, R.PH.
• Richard Crescent Rotella, M.D.
• Steelcore Rejuvenation

• Physical Therapy Assistant in Redington Beach, FL
• Providers in Redington Beach, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2016; 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.