Active NPI
Tommy Richard Edwards Jr., DPT
- Physical Therapist
- St Petersburg, FL
National Provider Identifier
1164713616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT26331
- Practice address
- 8601 4TH St N
Suite#101
St Petersburg, FL 33702-3108 - Phone
- (727) 579-7974
- NPI assigned
- May 2, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT26331 | FL | Primary |
Addresses
Primary practice location
8601 4TH St N
Suite#101
St Petersburg, FL 33702-3108
Mailing address
2550 Stag Run Blvd
Apt# 1015
Clearwater, FL 33765-1861
Phone (337) 238-8526
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT26331 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cora Health Services, Inc | Past | Accepting new patients | |
| Cora Health Services, Inc | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304294400000",
"number": "1164713616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 STAG RUN BLVD",
"address_2": "APT# 1015",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337651861",
"telephone_number": "337-238-8526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8601 4TH ST N",
"address_2": "SUITE#101",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337023108",
"telephone_number": "727-579-7974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "TOMMY",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-02",
"last_updated": "2011-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT26331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.