Active NPI
Blaine T Lepere, PT, DPT
- Physical Therapist
- Seminole, FL
National Provider Identifier
1316549124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT36576
- Practice address
- 11224 Park Blvd
Seminole, FL 33772-4752 - Phone
- (727) 394-0949
- NPI assigned
- Nov 16, 2020
- Sex
- Male
- Sole proprietor
- No
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 | PT36576 | FL | Primary |
Addresses
Primary practice location
11224 Park Blvd
Seminole, FL 33772-4752
Mailing address
6333 Dartmouth Ave N
St Petersburg, FL 33710-7747
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 |
|---|---|---|---|
| PT36576 | FL | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1316549124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6333 DARTMOUTH AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337107747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11224 PARK BLVD",
"city": "SEMINOLE",
"state": "FL",
"postal_code": "337724752",
"telephone_number": "727-394-0949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEPERE",
"first_name": "BLAINE",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT36576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seminole, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.