Individual provider Active NPI

Paul L Pearman Jr., PT, DPT, OCS

  • Physical Therapist
  • Eglin AFB, FL
National Provider Identifier
1245267475
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT14522 Issued in FL
Practice address
307 Boatner Rd
Suite 114
Eglin AFB, FL 32542-1391
Phone
(850) 883-9579
Fax
(850) 883-9581
NPI assigned
Jun 26, 2006
Last updated
Feb 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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 PT14522 FL Primary

Addresses

Primary practice location

307 Boatner Rd
Suite 114
Eglin AFB, FL 32542-1391

Mailing address

307 Boatner Rd
Suite 114
Eglin AFB, FL 32542-1391
Phone (850) 883-9579

Other identifiers 2

IdentifierTypeStateIssuer
891319600MedicaidFL
Y906WOtherFLBCBSFL GROUP#

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

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1245267475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "address_2": "SUITE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-9579",
            "fax_number": "850-883-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "address_2": "SUITE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-9579",
            "fax_number": "850-883-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARMAN",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PT,  DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT14522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891319600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL GROUP#",
            "identifier": "Y906W",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin AFB, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.