Active NPI
Kristine Dacey, PT
- Physical Therapist
- Port Orange, FL
National Provider Identifier
1275937393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 16808
- Practice address
- 941 Village TRL
Port Orange, FL 32127-9353 - Phone
- (386) 872-7511
- Fax
- (866) 781-1879
- NPI assigned
- Oct 17, 2014
- Sex
- Female
- 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 | PT 16808 | FL | Primary |
Addresses
Primary practice location
941 Village TRL
Port Orange, FL 32127-9353
Mailing address
PO Box 1975
Rome, GA 30162-1975
Phone (706) 204-8548
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT 16808 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413504000000",
"number": "1275937393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1975",
"city": "ROME",
"state": "GA",
"postal_code": "301621975",
"telephone_number": "706-204-8548",
"fax_number": "866-858-7371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "941 VILLAGE TRL",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321279353",
"telephone_number": "386-872-7511",
"fax_number": "866-781-1879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DACEY",
"first_name": "KRISTINE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-17",
"last_updated": "2014-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 16808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.