NPIMap

Organization Active NPI

Lake Area Physical Therapy Inc

Doing business as Lake Area Physical Therapy & Aquatics

  • Physical Therapist
  • Melrose, FL
National Provider Identifier
1376682518
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LAKE AREA PHYSICAL THERAPY INC
Doing business as
Lake Area Physical Therapy & Aquatics
Lake Area Physical Therapy & Aquatics Inc.
Practice address
25727 NE State Rd 26
Melrose, FL 32666-1099
Phone
(352) 475-3113
Fax
(352) 475-5796
NPI assigned
Feb 5, 2007
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Ms. Laura Hodges, PTNPI 1649280785
Title
Owner
Phone
(352) 475-3113

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

25727 NE State Rd 26
Melrose, FL 32666-1099

Mailing address

PO Box 1099
Melrose, FL 32666-1099
Phone (352) 475-3113

Other identifiers 5

IdentifierTypeStateIssuer
106944OtherFLMEDICARE
103999OtherFLAVMED PROVIDER #
880554700MedicaidFL
5941306OtherFLAETNA PROV#
R8JOtherFLBLUE CROSS PROV#

Other names 2

  • Lake Area Physical Therapy & Aquatics Doing business as
  • Lake Area Physical Therapy & Aquatics Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100702000028 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3678604840 Practice locations: Keystone Heights, FL; Melrose, FL; Starke, FL
O20110331000588 FL DME Supplier - Independently-Practicing Physical Therapist 3678604840 Practice locations: Melrose, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376682518. Details of each certification follow.

  • CCN 106944 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 106944

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LAKE AREA PHYSICAL THERAPY INC
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Aug 8, 1996
Last certification
Dec 17, 2025
Ownership / control type
Proprietary
Facility address
25727 NE State Rd 26
Melrose, FL 32666

National Provider Directory

National Provider Directory

Locations

6110 SE 205th St
Hawthorne, FL 32640
Phone (352) 475-3113

465 S Lawrence Blvd
Keystone Hgts, FL 32656
Phone (352) 473-7560

1554 S Water St
Starke, FL 32091
Phone (904) 964-2208

Practitioners & affiliated clinicians

Practitioners 376

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.

View all 376

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1376682518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1099",
            "city": "MELROSE",
            "state": "FL",
            "postal_code": "326661099",
            "telephone_number": "352-475-3113",
            "fax_number": "352-475-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25727 NE STATE RD 26",
            "city": "MELROSE",
            "state": "FL",
            "postal_code": "326661099",
            "telephone_number": "352-475-3113",
            "fax_number": "352-475-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE AREA PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-475-3113",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "106944",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED PROVIDER #",
            "identifier": "103999",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880554700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROV#",
            "identifier": "5941306",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROV#",
            "identifier": "R8J",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Area Physical Therapy & Aquatics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Area Physical Therapy & Aquatics Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melrose, FL

Sources for this page

Verify at the official NPI Registry.