Active NPI
Amber Cerveny, PTA
- Physical Therapy Assistant
- Jacksonville, FL
National Provider Identifier
1215390729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA26039
- Practice address
- 2080 Child St
Jacksonville, FL 32214-2323 - NPI assigned
- Apr 1, 2016
- 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 | PTA26039 | FL | Primary |
Addresses
Primary practice location
2080 Child St
Jacksonville, FL 32214-2323
Mailing address
72 Olivia Way
St Augustine, FL 32092-3558
Phone (561) 222-0323
Other practice location 1
80 Pinnacles Dr
Bldg B, Suite 800
Palm Coast, FL 32164-2323
Phone (386) 586-3887
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 |
|---|---|---|---|
| PTA26039 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747699200000",
"number": "1215390729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 OLIVIA WAY",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320923558",
"telephone_number": "561-222-0323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 CHILD ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322142323"
}
],
"practiceLocations": [
{
"address_1": "80 Pinnacles Dr",
"address_2": "Bldg B, Suite 800",
"address_purpose": "LOCATION",
"city": "Palm Coast",
"state": "FL",
"postal_code": "321642323",
"country_code": "US",
"telephone_number": "386-586-3887",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CERVENY",
"first_name": "AMBER",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-01",
"last_updated": "2025-05-20",
"certification_date": "2025-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA26039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.