Individual provider Active NPI

Kevin Reynolds

  • Physical Therapist
  • Cape Coral, FL
National Provider Identifier
1235580309
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
31462 Issued in FL
Practice address
1715 Cape Coral Pkwy W
Cape Coral, FL 33914-7029
Phone
(239) 542-0900
NPI assigned
Jun 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 31462 FL Primary

Addresses

Primary practice location

1715 Cape Coral Pkwy W
Cape Coral, FL 33914-7029

Mailing address

1715 Cape Coral Pkwy W
Cape Coral, FL 33914-7029
Phone (239) 542-0900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180410001891 FL Practitioner - Physical Therapist in Private Practice 8325301088 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fitness Quest - Venice LLCGroup PAC ID 9739125964, 44 clinicians

Practice addresses (Care Compare)

400 Tamiami TRL S
Suite 210
Venice, FL 34285-2626
Phone 87746937782004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31462FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fitness Quest - Punta Gorda LLC Physical Therapist CurrentSince Jan 31, 2022 Accepting new patients
Fitness Quest - North Port LLC Physical Therapist CurrentSince Jan 31, 2022 Accepting new patients
Baylife Physical Therapy & Rehabilitation Inc Physical Therapist CurrentSince Sep 3, 2018 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Mar 12, 2018 Accepting new patients
Fitness Quest - Venice LLC Physical Therapist CurrentSince Feb 1, 2025 Accepting new patients
Aegis Group Practice, LLC Physical Therapist CurrentSince Mar 12, 2018 Accepting new patients
Fq0014 Physical Therapist CurrentSince Jan 31, 2022 Accepting new patients
Fitness Quest - Venice LLC CurrentSince Feb 1, 2025 Accepting new patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients
Fitness Quest-Port Charlotte LLC Physical Therapist CurrentSince Jan 31, 2022 Accepting new patients
Fq0016, LLC Physical Therapist CurrentSince Apr 20, 2022 Accepting new patients
Baylife Physical Therapy & Rehabilitation, Inc. Past Accepting new patients

Locations

3657 Cortez Rd W
Ste 110
Bradenton, FL 34210
Phone (941) 361-9020

10201 Arcos Ave
Ste 204
Estero, FL 33928
Phone (724) 223-2061

11930 Fairway Lakes Dr
Ste 103104
Fort Myers, FL 33913
Phone (239) 687-3224

11930 Fairway Lakes Dr
Fort Myers, FL 33913
Phone (239) 687-3224

3530 Sandalwood Cir
Naples, FL 34109
Phone (239) 770-4367

18900 N Tamiami Trl
Ste A5
North Ft Myers, FL 33903
Phone (239) 451-4922

2530 Bobcat Village Center Rd
Unit C
North Port, FL 34288
Phone (941) 426-7400

1649 Tamiami Trl
Ste 1A
Pt Charlotte, FL 33948
Phone (941) 743-6700

530 E Olympia Ave
#112
Punta Gorda, FL 33950
Phone (941) 575-7300

530 E Olympia Ave
Ste 112
Punta Gorda, FL 33950
Phone (941) 575-7300

8950 Dr Ml King Jr St N
Ste 101
St Petersburg, FL 33702
Phone (727) 520-0800

400 Tamiami Trl S
Ste 210
Venice, FL 34285
Phone (877) 469-3778

470 Johnson Rd
Ste 100
Washington, PA 15301

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1235580309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 CAPE CORAL PKWY W",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339147029",
            "telephone_number": "239-542-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 CAPE CORAL PKWY W",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339147029",
            "telephone_number": "239-542-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "31462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.