Individual provider Active NPI

Julia Wyatt Connor, PT, DPT

  • Physical Therapist
  • Kissimmee, FL
National Provider Identifier
1235637307
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT33025 Issued in FL
Practice address
831 Simpson Rd Ste 102
Kissimmee, FL 34744-5328
Phone
(407) 483-5757
NPI assigned
Jan 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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 PT33025 FL Primary

Addresses

Primary practice location

831 Simpson Rd Ste 102
Kissimmee, FL 34744-5328

Mailing address

14001 Sanctuary Creek Way Unit 307
Orlando, FL 32832-6615
Phone (704) 692-2881

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220210000941 FL Practitioner - Physical Therapist in Private Practice 6002209251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stern at Home Physical Therapy PC Physical Therapist CurrentSince Jan 15, 2022 Accepting new patients
Connect Physical Therapy LLC Current Accepting new patients
Dedicated Physical Therapy and Wellness LLC Physical Therapist CurrentSince Feb 4, 2022 Accepting new patients

Locations

4 Medical Park Dr
Ste B
Pomona, NY 10970
Phone (845) 354-3131

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1235637307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 SANCTUARY CREEK WAY UNIT 307",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326615",
            "telephone_number": "704-692-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 SIMPSON RD STE 102",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445328",
            "telephone_number": "407-483-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "JULIA",
        "middle_name": "WYATT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-24",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT33025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.