Individual provider Active NPI

Janice Lynn Burnett, PTA

  • Physical Therapy Assistant
  • Lake Worth, FL
National Provider Identifier
1164795043
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA23169 Issued in FL
Practice address
4110 Tivoli CT
#106
Lake Worth, FL 33467-4097
Phone
(561) 414-8684
NPI assigned
Feb 22, 2012
Last updated
Feb 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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 PTA23169 FL Primary

Addresses

Primary practice location

4110 Tivoli CT
#106
Lake Worth, FL 33467-4097

Mailing address

4110 Tivoli CT
#106
Lake Worth, FL 33467-4097
Phone (561) 414-8684

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
PTA23169FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1164795043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 TIVOLI CT",
            "address_2": "#106",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334674097",
            "telephone_number": "561-414-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 TIVOLI CT",
            "address_2": "#106",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334674097",
            "telephone_number": "561-414-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "JANICE",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.