Active NPI
Bobbie June Waldroop
- Physical Therapy Assistant
- Ormond Beach, FL
National Provider Identifier
1194953281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 21308
- Practice address
- 350 S Ridgewood Ave
Ormond Beach, FL 32174-7028 - Phone
- (986) 677-4545
- NPI assigned
- Jun 26, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 21308 | FL | Primary |
Addresses
Primary practice location
350 S Ridgewood Ave
Ormond Beach, FL 32174-7028
Mailing address
34 Lloyd TRL
Palm Coast, FL 32164-5836
Phone (386) 597-3854
Other names 1
- Bobbie June Waldroop
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21308 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245974400000",
"number": "1194953281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 LLOYD TRL",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321645836",
"telephone_number": "386-597-3854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 S RIDGEWOOD AVE",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321747028",
"telephone_number": "986-677-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDROOP",
"first_name": "BOBBIE",
"middle_name": "JUNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-26",
"last_updated": "2009-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "21308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BOBBIE",
"last_name": "WALDROOP",
"middle_name": "JUNE",
"credential": "PTA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.