Individual provider Active NPI

Jesse Myers, DPT

  • Physical Therapist
  • Palm Harbor, FL
National Provider Identifier
1306367099
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
35095 US 19 N
Palm Harbor, FL 34684-2686
Phone
(727) 475-5538
NPI assigned
Jul 3, 2017
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 297848 CA
Physical Therapist 225100000X PT32692 FL
Physical Therapist 225100000X PT026609 PA
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

35095 US 19 N
Palm Harbor, FL 34684-2686

Mailing address

3903 Northdale Blvd
Ste 111W
Tampa, FL 33624-1853
Phone (727) 475-5538

Other practice location 1

612 Druid Rd E Ste D
Clearwater, FL 33756-3912
Phone (727) 475-5543

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
297848CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Physical Therapy Inc Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1306367099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 NORTHDALE BLVD",
            "address_2": "STE 111W",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241853",
            "telephone_number": "727-475-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35095 US 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346842686",
            "telephone_number": "727-475-5538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 Druid Rd E Ste D",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337563912",
            "country_code": "US",
            "telephone_number": "727-475-5543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JESSE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297848",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32692",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026609",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.