Individual provider Active NPI

Wayne Arthur Goffin I

  • Orthopedic Physical Therapist
  • Port Charlotte, FL
National Provider Identifier
1326090143
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 7920 Issued in FL
Practice address
17751 Murdock Cir
Port Charlotte, FL 33948-1034
Phone
(941) 743-8700
Fax
(941) 743-8850
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT 7920 FL Primary

Addresses

Primary practice location

17751 Murdock Cir
Port Charlotte, FL 33948-1034

Mailing address

17751 Murdock Cir
Port Charlotte, FL 33948-1034
Phone (941) 743-8700

Other identifiers 1

IdentifierTypeStateIssuer
Y911KOtherFLBC/BS

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
PT 7920FLMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fyzbiz, LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1326090143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17751 MURDOCK CIR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481034",
            "telephone_number": "941-743-8700",
            "fax_number": "941-743-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17751 MURDOCK CIR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481034",
            "telephone_number": "941-743-8700",
            "fax_number": "941-743-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFFIN",
        "first_name": "WAYNE",
        "middle_name": "ARTHUR",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT 7920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y911K",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.