Individual provider Active NPI

Cheryl Yvonne Crosby

  • Physical Therapy Assistant
  • Eustis, FL
National Provider Identifier
1366730368
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 22677 Issued in FL
Practice address
2810 Ruleme St
Eustis, FL 32726-6527
Phone
(269) 352-5987
NPI assigned
Jul 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502002000 MI
Physical Therapy Assistant 225200000X PTA 22677 FL Primary

Addresses

Primary practice location

2810 Ruleme St
Eustis, FL 32726-6527

Mailing address

623 N Bay St
Unit 20
Eustis, FL 32726-2958

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
PTA 22677FLMDPhysical Therapy Assistant
5502002000MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1366730368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 N BAY ST",
            "address_2": "UNIT 20",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327262958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 RULEME ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266527",
            "telephone_number": "269-352-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "CHERYL",
        "middle_name": "YVONNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502002000",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 22677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.