Individual provider Active NPI

Linda Bowman Driggers, PTA

  • Physical Therapy Assistant
  • Leesburg, FL
National Provider Identifier
1174645535
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 18309 Issued in FL
Practice address
600 W North Blvd
Leesburg, FL 34748-5063
Phone
(352) 787-9300
NPI assigned
Apr 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PTA 18309 FL Primary

Addresses

Primary practice location

600 W North Blvd
Leesburg, FL 34748-5063

Mailing address

2950 SE 157TH Lane Rd
Summerfield, FL 34491-5097
Phone (352) 787-9300

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
PTA 18309FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174645535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 SE 157TH LANE RD",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344915097",
            "telephone_number": "352-787-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W NORTH BLVD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485063",
            "telephone_number": "352-787-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRIGGERS",
        "first_name": "LINDA",
        "middle_name": "BOWMAN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 18309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.