Individual provider Active NPI

Lawrence Allen Fossitt, M.P.T., C.F.M.T.

  • Physical Therapist
  • Sanford, FL
National Provider Identifier
1346310026
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT19048 Issued in FL
Practice address
2015 S Maple Ave
Sanford, FL 32771-3361
Phone
(407) 328-5420
Fax
(407) 328-5430
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT19048 FL Primary

Addresses

Primary practice location

2015 S Maple Ave
Sanford, FL 32771-3361

Mailing address

289 Brassington Drive
Debary, FL 32713
Phone (407) 792-8590

Other identifiers 2

IdentifierTypeStateIssuer
PT19048OtherFLPROFESSIONAL LICENSE NUM.
Y045ROtherFLBCBSFL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050907000445 FL Practitioner - Physical Therapist in Private Practice 9335171974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2015 S Maple Ave
Sanford, FL 32771-3361
Phone (407) 328-5420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fossitt Therapy Services, Inc. CurrentSince May 26, 2005 Accepting new patients

Locations

2015 S Maple Ave
Sanford, FL 32771
Phone (407) 328-5420

Networks

  • Freedom Health HMO Network

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1346310026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 BRASSINGTON DRIVE",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "32713",
            "telephone_number": "407-792-8590",
            "fax_number": "407-328-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 S MAPLE AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327713361",
            "telephone_number": "407-328-5420",
            "fax_number": "407-328-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSSITT",
        "first_name": "LAWRENCE",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "M.P.T., C.F.M.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE NUM.",
            "identifier": "PT19048",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL NUMBER",
            "identifier": "Y045R",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.