John Miles Frisvold, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT21516 Issued in FL

Practice address

3715 Crill Ave
Palatka, FL 32177-9168

Phone

(386) 329-2613

Fax

(386) 329-2614

NPI assigned

Sep 28, 2006

Last updated

Mar 14, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palatka Physical Therapy LLCGroup PAC ID 6507955689, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Palatka Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Palatka, FL
  • NPI 1619169661

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1336230796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E FOREST PARK DR",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776605",
            "telephone_number": "386-937-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779168",
            "telephone_number": "386-329-2613",
            "fax_number": "386-329-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRISVOLD",
        "first_name": "JOHN",
        "middle_name": "MILES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y115R",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florida Cancer Specialists & Research Institute, LLC
• Florida Department of Health
• Florida Therapeutic Massage
• Mia Flowers, PHARMD, RPH
• Alyssa Lynne Fraser, MS CCC SLP
• Marquise M Fuce
• Paula B. Fuller, CRNA
• Functional Living Therapy Services PLLC
• Kevin Andre Funk, M.D.
• Latonya N Fuqua

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.