Active NPI
Reginald Stewart, PERSONAL TRAINER
- Physical Therapist
- West Palm Beach, FL
National Provider Identifier
1346541398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 08429
- Practice address
- 4364 Forest Hill Blvd
West Palm Beach, FL 33406-5718 - Phone
- (561) 798-8013
- Fax
- (561) 881-2168
- NPI assigned
- Nov 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 08429 | FL | Primary |
Addresses
Primary practice location
4364 Forest Hill Blvd
West Palm Beach, FL 33406-5718
Mailing address
4364 Forest Hill Blvd
West Palm Beach, FL 33406-5718
Phone (561) 798-8013
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2010-08429 | Other | FL | LICENSE NUMBER |
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 |
|---|---|---|---|
| 08429 | FL | MD | Physical Therapist |
Interoperability endpoints
- https://api.platform.athenahealth.com/23384/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289174400000",
"number": "1346541398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4364 FOREST HILL BLVD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334065718",
"telephone_number": "561-798-8013",
"fax_number": "561-881-2168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4364 FOREST HILL BLVD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334065718",
"telephone_number": "561-798-8013",
"fax_number": "561-881-2168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "REGINALD",
"credential": "PERSONAL TRAINER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-08",
"last_updated": "2010-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "08429",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "2010-08429",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.