Optimal Performance & Physical Therapies Winter Haven, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

OPTIMAL PERFORMANCE & PHYSICAL THERAPIES WINTER HAVEN, LLC

Practice address

5535 Cypress Gardens Blvd Ste 260
Winter Haven, FL 33884-2241

Phone

(727) 475-5540

NPI assigned

Jun 20, 2019

Organization subpart

No

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

Authorized official

Name

Beth Patterson, PT

Title

Chief Compliance Officer/Owner

Phone

(813) 690-4414

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blair Gaston

  • Physical Therapist
  • Winter Haven, FL
  • NPI 1487260790
  Medicare reassignment Care Compare group NPD
• Kayla Riley

  • Physical Therapist
  • Winter Haven, FL
  • NPI 1558213447
  Medicare reassignment Care Compare group NPD
• Nicholas Vultaggio

  • Physical Therapist
  • Winter Haven, FL
  • NPI 1346851839
  Medicare reassignment Care Compare group NPD
• Ariel Evans

  • Physical Therapist
  • Lakeland, FL
  • NPI 1881394542
  Medicare reassignment NPD
• Kristen Kleponis, PT, DPT, PRPC

  • Physical Therapist
  • Lakeland, FL
  • NPI 1972105328
  Medicare reassignment NPD
• Duaa Osman

  • Physical Therapist
  • Lakeland, FL
  • NPI 1346137064
  Medicare reassignment NPD
• Christopher Warren Greaves, DPT

  • Physical Therapist
  • Mesa, AZ
  • NPI 1740901818

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577145600000",
    "number": "1336709369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21756 STATE ROAD 54 STE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492905",
            "telephone_number": "727-475-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 CYPRESS GARDENS BLVD STE 260",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338842241",
            "telephone_number": "727-475-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL PERFORMANCE & PHYSICAL THERAPIES WINTER HAVEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER/OWNER",
        "authorized_official_telephone_number": "813-690-4414",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT4616",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa G. Olmsted, D.C.
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• Luis Alberto Ordonez, D.D.S.
• Carolina Orozco Upegui
• Jimmy Orphee, D.M.D.
• Michael G Ort, M.D.
• Orthopaedic Medical Group of Tampa Bay PA

• Physical Therapist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.