NPIMap

Organization Active NPI

Optimal Performance and Physical Therapies St. Joes LLC

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1174831523
Registry record updated Oct 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES ST. JOES LLC
Practice address
2700 W Dr Martin Luther King Jr Blvd
Suite 300
Tampa, FL 33607-6386
Phone
(813) 805-8108
NPI assigned
Sep 20, 2010
Last updated
Oct 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2010

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

Authorized official

Name
Mrs. Beth Ann Patterson, PTNPI 1215051776
Title
Secretary
Phone
(813) 690-4414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

2700 W Dr Martin Luther King Jr Blvd
Suite 300
Tampa, FL 33607-6386

Mailing address

6023 Hammock Woods Dr
Odessa, FL 33556-3330
Phone (813) 690-4414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101108000955 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3971798687 Receives reassigned benefits from 7 practitioners
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

2700 W Mlk Blvd
Ste 300
Tampa, FL 33607
Phone (813) 805-8108

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287878400000",
    "number": "1174831523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6023 HAMMOCK WOODS DR",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335563330",
            "telephone_number": "813-690-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W DR MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076386",
            "telephone_number": "813-805-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES ST. JOES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-10-24",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "813-690-4414",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2010; 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.