Individual provider Active NPI

Athena Brown

  • Physical Therapist
  • Jacksonville Beach, FL
National Provider Identifier
1285505701
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28773 Issued in FL
Practice address
1315 2ND Ave N
Jacksonville Beach, FL 32250-3694
Phone
(919) 424-5080
NPI assigned
Sep 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT28773 FL Primary

Addresses

Primary practice location

1315 2ND Ave N
Jacksonville Beach, FL 32250-3694

Mailing address

6989 Azalea Grove Dr
Jacksonville, FL 32258-8519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009004473 FL Practitioner - Physical Therapist in Private Practice 9234636663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

1315 2ND Ave N
Jacksonville, FL 32250-3694
Phone (904) 746-7917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28773FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc Physical Therapist CurrentSince Sep 22, 2025 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Sep 22, 2025 Accepting new patients

Locations

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

1315 2nd Ave N
Jax Bch, FL 32250
Phone (904) 615-8076

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1757980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1285505701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6989 AZALEA GROVE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322588519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 2ND AVE N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503694",
            "telephone_number": "919-424-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ATHENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.