Individual provider Active NPI

Bryant Villota, DPT

  • Physical Therapist
  • St Petersburg, FL
National Provider Identifier
1235773060
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT35160 Issued in FL
Practice address
4600 4TH St N
St Petersburg, FL 33703-3802
Phone
(727) 527-5272
NPI assigned
Nov 5, 2019
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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 PT35160 FL Primary

Addresses

Primary practice location

4600 4TH St N
St Petersburg, FL 33703-3802

Mailing address

4600 4TH St N
St Petersburg, FL 33703-3802
Phone (727) 527-5272

Other practice location 1

13335 W Hillsborough Ave
Tampa, FL 33635-9676
Phone (813) 849-0150

Other identifiers 1

IdentifierTypeStateIssuer
PT35160OtherFLLICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT35160FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crossover Physical Therapy and Performance LLC Current Accepting new patients
Musculoskeletal Institute Chartered Current Accepting new patients
Musculoskeletal Institute Chartered CurrentSince May 10, 2021 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince May 10, 2021 Accepting new patients

Locations

4600 4th St N
St Petersburg, FL 33703

13020 N Telecom Pkwy
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1235773060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033802",
            "telephone_number": "727-527-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033802",
            "telephone_number": "727-527-5272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13335 W Hillsborough Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336359676",
            "country_code": "US",
            "telephone_number": "813-849-0150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLOTA",
        "first_name": "BRYANT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-05",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT35160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PT35160",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.