Individual provider Active NPI

Jeffrey Gene Poirier, PT

  • Physical Therapist
  • Cape Coral, FL
National Provider Identifier
1174818801
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT25684 Issued in FL
Practice address
1425 Viscaya Pkwy
Suite 205
Cape Coral, FL 33990-3294
Phone
(239) 772-2363
NPI assigned
Jun 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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 PT25684 FL Primary

Addresses

Primary practice location

1425 Viscaya Pkwy
Suite 205
Cape Coral, FL 33990-3294

Mailing address

4790 S Cleveland Ave
Apt 2005
Fort Myers, FL 33907-1300
Phone (239) 772-2363

Other identifiers 1

IdentifierTypeStateIssuer
PT25684OtherFLFLORIDA PT LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110727000573 FL Practitioner - Physical Therapist in Private Practice 4486822921 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Health and Rehab of Punta Gorda Physical Therapist CurrentSince Jul 12, 2023 Accepting new patients
The Villages Rehabilitation Services LLC Past Accepting new patients
Neuroscience and Spine Associates PL Past Accepting new patients

Locations

2905 Tamiami Trl
Punta Gorda, FL 33950
Phone (941) 205-2180

324 Cross St
Punta Gorda, FL 33950
Phone (941) 205-2180

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1174818801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 S CLEVELAND AVE",
            "address_2": "APT 2005",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071300",
            "telephone_number": "239-772-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 VISCAYA PKWY",
            "address_2": "SUITE 205",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903294",
            "telephone_number": "239-772-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POIRIER",
        "first_name": "JEFFREY",
        "middle_name": "GENE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT25684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA PT LICENSE NUMBER",
            "identifier": "PT25684",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.