James Robert Dutkiewicz, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA11849 Issued in FL

Practice address

2364 Stonebridge Dr
Orange Park, FL 32065-5769

Phone

(904) 866-0263

NPI assigned

Aug 22, 2023

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": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1376327270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 STONEBRIDGE DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320655769",
            "telephone_number": "904-866-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 STONEBRIDGE DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320655769",
            "telephone_number": "904-866-0263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2140 Kingsley Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735129",
            "country_code": "US",
            "telephone_number": "904-272-2830",
            "fax_number": "904-272-8814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUTKIEWICZ",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA11849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Thomas Dupuy III, DO
• Christian John Dupuy, DO
• Emily Durden
• Celia Dure, BSN, RN
• Barney Van Durham II, D.C.
• Jurnee Dutremble
• Rachel Dykes
• Lisa Ann Dynan-Dobbertien, D.O.
• Shauna A Dysart
• Early Intervention Therapy Services, LLC.

• Physical Therapy Assistant in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.