Andrew Thien Duong

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

41956 Issued in FL

Practice address

400 Sterling Plaza Dr Ste 407
Ponte Vedra Beach, FL 32081-8562

Phone

(904) 514-2571

NPI assigned

Oct 8, 2024

Last updated

Oct 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1356160204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9972 MAXWOOD CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578617",
            "telephone_number": "904-514-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 STERLING PLAZA DR STE 407",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320818562",
            "telephone_number": "904-514-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "ANDREW",
        "middle_name": "THIEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "FL",
            "license": "41956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Physical Therapist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Sports Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.