Individual provider Active NPI

Priyal Alkesh Patel

  • Physical Therapy Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1285493551
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT41445 Issued in FL
Practice address
644 Cesery Blvd Ste 103
Jacksonville, FL 32211-7165
Phone
(904) 903-2755
Fax
(904) 903-2756
NPI assigned
Mar 18, 2024
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT41445 FL Primary

Addresses

Primary practice location

644 Cesery Blvd Ste 103
Jacksonville, FL 32211-7165

Mailing address

105 Southpark Blvd Ste B201
Saint Augustine, FL 32086-5159
Phone (904) 824-1636

Other practice location 1

8081 Philips Hwy Ste 5
Jacksonville, FL 32256-7443
Phone (904) 872-3100

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
PT41445FLMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Rehabilitative Services Inc Physical Therapy Past Accepting new patients
Rebound Rehabilitative Services Inc Physical Therapy PastSince Sep 15, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1285493551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD STE B201",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865159",
            "telephone_number": "904-824-1636",
            "fax_number": "904-824-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 CESERY BLVD STE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322117165",
            "telephone_number": "904-903-2755",
            "fax_number": "904-903-2756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8081 Philips Hwy Ste 5",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322567443",
            "country_code": "US",
            "telephone_number": "904-872-3100",
            "fax_number": "904-872-3106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYAL",
        "middle_name": "ALKESH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT41445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.