NPIMap

Organization Active NPI

Premier Physical Therapy & Sports Medicine

  • Physical Therapist
  • Stuart, FL
National Provider Identifier
1366113771
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PREMIER PHYSICAL THERAPY & SPORTS MEDICINE
Practice address
2026 SE Ocean Blvd
Stuart, FL 34996-3304
Phone
(772) 888-3360
Fax
(772) 210-6842
NPI assigned
Sep 24, 2021
Last updated
Oct 18, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PREMIER PHYSICAL THERAPY & SPORTS MEDICINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Authorized official

Name
Jeffrey Alan TuckerNPI 1982725230
Title
Owner
Phone
(772) 335-7966

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

2026 SE Ocean Blvd
Stuart, FL 34996-3304

Mailing address

PO Box 8600
Port Saint Lucie, FL 34985-8600

National Provider Directory

National Provider Directory
Tax ID family
Premier Physical Therapy Sports Medicine8 organizations share this tax ID, including this one
Part of
Premier Physical Therapy Sports Medicine

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2010 SE Ocean Blvd
Stuart, FL 34996

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1366113771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8600",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349858600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 SE OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349963304",
            "telephone_number": "772-888-3360",
            "fax_number": "772-210-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICAL THERAPY & SPORTS MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER PHYSICAL THERAPY & SPORTS MEDICINE",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-335-7966"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.