Active NPI
Joel Pung, RPT
- Physical Therapist
- Palmetto, FL
National Provider Identifier
1336419282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT11721
- Practice address
- 2825 Terra Ceia Bay Blvd
# 1702
Palmetto, FL 34221-5989 - Phone
- (941) 447-7274
- NPI assigned
- Jan 10, 2012
- 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 | PT11721 | FL | Primary |
Addresses
Primary practice location
2825 Terra Ceia Bay Blvd
# 1702
Palmetto, FL 34221-5989
Mailing address
2825 Terra Ceia Bay Blvd
# 1702
Palmetto, FL 34221-5989
Phone (941) 447-7274
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 |
|---|---|---|---|
| PT11721 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461801600000",
"number": "1336419282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 TERRA CEIA BAY BLVD",
"address_2": "# 1702",
"city": "PALMETTO",
"state": "FL",
"postal_code": "342215989",
"telephone_number": "941-447-7274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 TERRA CEIA BAY BLVD",
"address_2": "# 1702",
"city": "PALMETTO",
"state": "FL",
"postal_code": "342215989",
"telephone_number": "941-447-7274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUNG",
"first_name": "JOEL",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-10",
"last_updated": "2016-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT11721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.