Active NPI
Tracy Pamela Garrett, P.T.
- Physical Therapist
- West Palm Beach, FL
National Provider Identifier
1295728541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 5565
- Practice address
- 4569 Wadita Ka Way
West Palm Beach, FL 33417-8014 - Phone
- (561) 478-0964
- NPI assigned
- Aug 23, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 5565 | FL | Primary |
Addresses
Primary practice location
4569 Wadita Ka Way
West Palm Beach, FL 33417-8014
Mailing address
4569 Wadita Ka Way
West Palm Beach, FL 33417-8014
Phone (561) 478-0964
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 888749700 | Medicaid | FL | |
| 810591000 | Medicaid | FL |
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 5565 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1295728541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4569 WADITA KA WAY",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334178014",
"telephone_number": "561-478-0964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4569 WADITA KA WAY",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334178014",
"telephone_number": "561-478-0964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRETT",
"first_name": "TRACY",
"middle_name": "PAMELA",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-23",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 5565",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "888749700",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "810591000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.