Audrey Liberty Merritt, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

31410 Issued in FL

Practice address

4113C NW 6TH St Ste C
Gainesville, FL 32609-1749

Phone

(352) 376-6300

Fax

(352) 372-0661

NPI assigned

Feb 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Audrey Ellen Liberty Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570924800000",
    "number": "1376678383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 NW 6TH ST STE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326090731",
            "telephone_number": "352-376-6300",
            "fax_number": "352-372-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113C NW 6TH ST STE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326091749",
            "telephone_number": "352-376-6300",
            "fax_number": "352-372-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "AUDREY",
        "middle_name": "LIBERTY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2019-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1105245",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "31410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "31410",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "LIBERTY",
            "middle_name": "ELLEN",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valerie Denise Merricks
• Alvin Merriex Jr.
• Katesha M. Merriex, RN
• Kendrick Merriex
• John Wesley Merriman III, M.D.
• Charnette Merritt
• Parker Merritt, M.D.
• Sunni Mesete
• Joseph Messana, M.D.
• Evelyn Rae Messer, PHARMD

• Physical Therapist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.