Active NPI
Ronald Marteeny
- Physical Therapy Assistant
- Daytona Beach, FL
National Provider Identifier
1326628439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 12635
- Practice address
- 595 N Williamson Blvd
Daytona Beach, FL 32114-7185 - Phone
- (386) 257-4400
- NPI assigned
- Apr 12, 2021
- 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 Therapy Assistant | 225200000X | 12635 | FL | Primary |
Addresses
Primary practice location
595 N Williamson Blvd
Daytona Beach, FL 32114-7185
Mailing address
4486 Chalmette CT
Port Orange, FL 32127-9283
Phone (386) 307-9576
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 |
|---|---|---|---|
| 12635 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1326628439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4486 CHALMETTE CT",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321279283",
"telephone_number": "386-307-9576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 N WILLIAMSON BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321147185",
"telephone_number": "386-257-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTEENY",
"first_name": "RONALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-12",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "12635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.