Keith Bradley Stark, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT21717 Issued in FL

Practice address

33100 US Highway 19 N
Palm Harbor, FL 34684-3127

Phone

(727) 789-6008

Fax

(727) 789-0716

NPI assigned

Mar 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Palm Harbor Physical Therapy

  • Physical Therapist
  • Palm Harbor, FL
  • NPI 1417957358
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1265565907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 TRANSOM CT",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075870",
            "telephone_number": "813-404-3799",
            "fax_number": "727-789-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33100 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843127",
            "telephone_number": "727-789-6008",
            "fax_number": "727-789-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "KEITH",
        "middle_name": "BRADLEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Stack
• Katherin Stairs, A.R.N.P
• Sable Leann Stamper, DPT
• Megan Stanley
• Piper Noelle Stannard Vanderlee, LCSW
• Fredric Russell Starling Jr., RPH
• Beverly M Stasis, L.M.T.
• Eric Steckler, M.D.
• Lilia Rene Stefaniwsky, MD
• Miranda L Steininger, APRN

• Physical Therapist in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.