Active NPI
Kyle Sanders
- Physical Therapist
- Navarre, FL
National Provider Identifier
1245752104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT29619
- Practice address
- 8199 Navarre Pkwy Ste 12a
Navarre, FL 32566-6941 - Phone
- (850) 939-1233
- Fax
- (850) 939-5097
- NPI assigned
- Jul 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT29619 | FL | Primary |
Addresses
Primary practice location
8199 Navarre Pkwy Ste 12a
Navarre, FL 32566-6941
Mailing address
PO Box 441146
Kennesaw, GA 30160-9522
Phone (678) 459-3745
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10000 | SC | MD | Prosthodontist |
| PT29619 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499817600000",
"number": "1245752104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 441146",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301609522",
"telephone_number": "16784593745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8199 NAVARRE PKWY STE 12A",
"city": "NAVARRE",
"state": "FL",
"postal_code": "325666941",
"telephone_number": "850-939-1233",
"fax_number": "850-939-5097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-12",
"last_updated": "2017-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT29619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Navarre, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.