Richard Carroll Bledsoe, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT26750 Issued in FL

Practice address

2501 South Volusia Ave
Suite 200
Orange City, FL 32763

Phone

(386) 774-6333

Fax

(888) 465-1815

NPI assigned

Sep 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Richard Carroll Bledsoe Professional name

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": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1376893180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 SOUTH VOLUSIA AVE",
            "address_2": "SUITE 200",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "32763",
            "telephone_number": "386-774-6333",
            "fax_number": "888-465-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 SOUTH VOLUSIA AVE",
            "address_2": "SUITE 200",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "32763",
            "telephone_number": "386-774-6333",
            "fax_number": "888-465-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "RICHARD",
        "middle_name": "CARROLL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICHARD",
            "last_name": "BLEDSOE",
            "middle_name": "CARROLL",
            "prefix": "MR.",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Physical Therapist in Orange City, FL
• Providers in Orange City, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.