Gary James Piacentine, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1410 Issued in FL

Practice address

820 W Lake Mary Blvd
102
Sanford, FL 32773-5946

Phone

(407) 321-6644

Fax

(407) 321-7309

NPI assigned

Oct 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lake Mary Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Sanford, FL
  • NPI 1316089568

  Physical Therapist

  NPD (past) Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316030174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W LAKE MARY BLVD",
            "address_2": "102",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735946",
            "telephone_number": "407-321-6644",
            "fax_number": "407-321-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W LAKE MARY BLVD",
            "address_2": "102",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735946",
            "telephone_number": "407-321-6644",
            "fax_number": "407-321-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIACENTINE",
        "first_name": "GARY",
        "middle_name": "JAMES",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT1410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NUMBER",
            "identifier": "Y922P",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE #",
            "identifier": "PT1410",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justine Philbin, O.D.
• Marie B Phillip
• Klaudya Phillips
• Physical Therapy Now Sanford LLC (Physical Therapy Now Sanford)
• Physician Associates LLC
• Picc Central LLC
• Alyssia Pierce, CPT, CCMA
• Robert Donald Pierre II, D.M.D.
• Aravind N Pillai, MD
• Suzanne Beth Pinsky, PHARMD

• Physical Therapist in Sanford, FL
• Providers in Sanford, FL by specialty
• Physical Therapist in Florida

• 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.