Country Club PT PA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT20257 Issued in FL

Legal business name

COUNTRY CLUB PT PA

Practice address

13200 Eastpointe Way
West Palm Beach, FL 33418-1418

Phone

(561) 632-2160

Fax

(561) 842-6458

NPI assigned

Sep 10, 2010

Last updated

Sep 18, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bradley Nolin, MPTNPI 1821044249

Title

Owner/Therapist

Phone

(561) 632-2160

Specialties & licenses 1

Addresses

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Nolin, MPT

  • Physical Therapist
  • Palm Beach Gardens, FL
  • NPI 1821044249
  Authorized official Same address or phone
• Susan Gammon, P.T.

  • Physical Therapist
  • Venice, FL
  • NPI 1841308707
  NPD
• Amy Boyd, MPT

  • Physical Therapist
  • Palm Beach Gardens, FL
  • NPI 1114134939
  NPD (past)
• Oscar Manuel Flores

  • Specialist
  • Jupiter, FL
  • NPI 1073657243
  NPD (past)
• Jason Joyner, MPT, DPT

  • Physical Therapist
  • Solon, OH
  • NPI 1427030105
  NPD (past)

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1174830202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 US HIGHWAY 1 STE 216",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334084905",
            "telephone_number": "561-632-2160",
            "fax_number": "561-842-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13200 EASTPOINTE WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334181418",
            "telephone_number": "561-632-2160",
            "fax_number": "561-842-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY CLUB PT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-10",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "NOLIN",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "561-632-2160",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rene Coto Borges, M.D.
• Hope Cotto Lopez
• Ali Anderson Coulas, RN
• Anneliese Valery Coule, LAC
• Joan Linda Counterman, MSW
• Herman Courage
• Pamela Lynne Coutu
• Covalent Medical Management LLC
• Harvey Cove, MD
• Franye Coverman, LCSW

• Physical Therapist in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.