Individual provider Active NPI

Sidney Roundy Bauman, PT, DPT

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1164196580
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT35881 Issued in FL
Practice address
4500 San Pablo Rd
Jacksonville, FL 32224
Phone
(904) 953-2000
NPI assigned
Aug 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT35881 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd
Jacksonville, FL 32224

Mailing address

4500 San Pablo Rd
Jacksonville, FL 32224
Phone (904) 953-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sroundy965258@ehrdirect.mayoclinicmsg.org

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT35881FLMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: sroundy965258@ehrdirect.mayoclinicmsg.org

NPI Registry JSON

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1164196580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32224",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32224",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMAN",
        "first_name": "SIDNEY",
        "middle_name": "ROUNDY",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT35881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sroundy965258@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.