NPIMap

Organization Active NPI

Gainesville Physical Therapy & Wellness LLC

  • Physical Therapist
  • Gainesville, FL
National Provider Identifier
1205910320
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12687 Issued in FL
Legal business name
GAINESVILLE PHYSICAL THERAPY & WELLNESS LLC
Practice address
4113 NW 6TH St Ste C
Gainesville, FL 32609-0731
Phone
(352) 376-6300
Fax
(352) 372-0661
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Authorized official

Name
Mr. David C Lower, DPT
Title
Member Manager
Phone
(352) 376-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT12687 FL Primary

Addresses

Primary practice location

4113 NW 6TH St Ste C
Gainesville, FL 32609-0731

Mailing address

4113 NW 6TH St Ste C
Gainesville, FL 32609-0731
Phone (352) 376-6300

Other identifiers 2

IdentifierTypeStateIssuer
Y912SOtherFLBCBS
DH0372OtherFLRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

2207 NW 13th St
Gainesville, FL 32609
Phone (352) 376-6300

Practitioners & affiliated clinicians

Practitioners 11

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1205910320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 NW 6TH ST STE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326090731",
            "telephone_number": "352-376-6300",
            "fax_number": "352-372-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 NW 6TH ST STE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326090731",
            "telephone_number": "352-376-6300",
            "fax_number": "352-372-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINESVILLE PHYSICAL THERAPY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "LOWER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "352-376-6300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT12687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y912S",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DH0372",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.