Individual provider Active NPI

Serena Dunham, PHYSICAL THERAPIST

  • Physical Therapist
  • Gulf Breeze, FL
National Provider Identifier
1306970744
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0003720 Issued in FL
Practice address
1040 Gulf Breeze Pkwy
Firstrehab
Gulf Breeze, FL 32561-4838
Phone
(850) 942-2180
Fax
(850) 934-4181
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT0003720 FL Primary

Addresses

Primary practice location

1040 Gulf Breeze Pkwy
Firstrehab
Gulf Breeze, FL 32561-4838

Mailing address

8047 Northpointe Blvd
Pensacola, FL 32514-6542
Phone (850) 342-6917

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
PT0003720FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306970744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8047 NORTHPOINTE BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146542",
            "telephone_number": "850-342-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PKWY",
            "address_2": "FIRSTREHAB",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614838",
            "telephone_number": "850-942-2180",
            "fax_number": "850-934-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNHAM",
        "first_name": "SERENA",
        "name_prefix": "Miss",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT0003720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.