NPIMap

Organization Active NPI

Omspt Holdings LLC

  • Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1194485367
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OMSPT HOLDINGS LLC
Practice address
14561 Jetport Loop; BLDG #200. Suite 135
Jetport Commerce Park
Fort Myers, FL 33913-3391
Phone
(606) 324-0540
Fax
(606) 324-0616
NPI assigned
Dec 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Authorized official

Name
Beverly S Ritchey
Title
Administrative Assistant
Phone
(606) 324-0540

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

14561 Jetport Loop; BLDG #200. Suite 135
Jetport Commerce Park
Fort Myers, FL 33913-3391

Mailing address

1212 Bath Ave Ste 350
Ashland, KY 41101-2696
Phone (606) 324-0540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220718001627 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1850789066 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Myers, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Omspt Holdings LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13050 Metro Pkwy
Fort Myers, FL 33966

14561 Jetport Loop
Bldg 200
Fort Myers, FL 33913
Phone (239) 313-6109

14561 Jetport Loop
Fort Myers, FL 33913
Phone (239) 313-6109

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1194485367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 BATH AVE STE 350",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012696",
            "telephone_number": "606-324-0540",
            "fax_number": "606-324-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14561 JETPORT LOOP; BLDG #200. SUITE 135",
            "address_2": "JETPORT COMMERCE PARK",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339133391",
            "telephone_number": "606-324-0540",
            "fax_number": "606-324-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMSPT HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "RITCHEY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "606-324-0540"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.