Individual provider Active NPI

Earl Nottage, PTA

  • Physical Therapy Assistant
  • Miami, FL
National Provider Identifier
1245413301
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PT A011446 Issued in FL
Practice address
2115 SW 8TH St
Miami, FL 33135-3319
Phone
(305) 649-4616
Fax
(305) 649-3601
NPI assigned
Dec 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PT A011446 FL Primary

Addresses

Primary practice location

2115 SW 8TH St
Miami, FL 33135-3319

Mailing address

10825 SW 152ND Ter
Miami, FL 33157-1356
Phone (305) 799-8865

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

LicenseStateTypeSpecialty
PT A011446FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Rehab Services, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1245413301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10825 SW 152ND TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331571356",
            "telephone_number": "305-799-8865",
            "fax_number": "305-649-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331353319",
            "telephone_number": "305-649-4616",
            "fax_number": "305-649-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTTAGE",
        "first_name": "EARL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PT A011446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.