Individual provider Active NPI

Teresa Lynn Adams, PTA

  • Physical Therapy Assistant
  • Madison, FL
National Provider Identifier
1356687586
Registry record updated Dec 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA23660 Issued in FL
Practice address
456 W Base St
Madison, FL 32340-2061
Phone
(850) 973-2187
Fax
(850) 973-6536
NPI assigned
Dec 16, 2012
Last updated
Dec 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA23660 FL Primary

Addresses

Primary practice location

456 W Base St
Madison, FL 32340-2061

Mailing address

390 NW Gadwall Way
Madison, FL 32340-3313
Phone (850) 929-6949

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

LicenseStateTypeSpecialty
PTA23660FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1355616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355616000000",
    "number": "1356687586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 NW GADWALL WAY",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323403313",
            "telephone_number": "850-929-6949",
            "fax_number": "850-973-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 W BASE ST",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323402061",
            "telephone_number": "850-973-2187",
            "fax_number": "850-973-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-16",
        "last_updated": "2012-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2012; 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.