Jody Carl Andersen, ATC, PT

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

PT 20698 Issued in FL

Practice address

401 W Kennedy Blvd
Box 30F
Tampa, FL 33606-1450

Phone

(813) 257-3162

Fax

(813) 258-7482

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390176000000",
    "number": "1144293408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W KENNEDY BLVD",
            "address_2": "BOX 30F",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061450",
            "telephone_number": "813-257-3162",
            "fax_number": "813-258-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W KENNEDY BLVD",
            "address_2": "BOX 30F",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061450",
            "telephone_number": "813-257-3162",
            "fax_number": "813-258-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "JODY",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "ATC, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2014-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "FL",
            "license": "PT 20698",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 1654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Andersen
• Amy Andersen, ARNP
• Angela Andersen, MS, CCC-SLP
• Bailey Kamin Andersen, M.S.
• Bethany Burns Andersen, P.T.
• Philip H Andersen, MD
• Valerie Andersen, PSY.D.
• Theresa Lynn Anderson Bennati, APRN
• Erin Anderson Wells, PH.D.
• Vanessa Ileann Anderson-Alvarez, BS, BCABA

• Sports Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Sports Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; 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.