Individual provider Active NPI

Marjan Ahmadzada, DPT

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1174405013
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTT43357 Issued in FL
Practice address
5995-1 University Blvd W
Jacksonville, FL 32216
Phone
(904) 737-7173
NPI assigned
Jul 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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 PTT43357 FL Primary

Addresses

Primary practice location

5995-1 University Blvd W
Jacksonville, FL 32216

Mailing address

14462 Garden Gate Dr
Jacksonville, FL 32258-8477
Phone (904) 576-9236

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
PTT43357FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a . PastSince Jul 28, 2025 Accepting new patients
Occupational Health Centers of the Southwest P.a. PastSince Jul 28, 2025 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1753142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1174405013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14462 GARDEN GATE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322588477",
            "telephone_number": "904-576-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995-1 UNIVERSITY BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-737-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMADZADA",
        "first_name": "MARJAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PTT43357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jul 22, 2025; 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.