NPIMap

Organization Active NPI

T.B.C. Ventures LLC

  • Physical Therapist
  • Clearwater, FL
National Provider Identifier
1386179158
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT19198 Issued in FL
Legal business name
T.B.C. VENTURES LLC
Practice address
1501 N Belcher Rd Ste 166
Clearwater, FL 33765-1339
Phone
(727) 251-8903
Fax
(727) 216-6999
NPI assigned
Apr 28, 2017
Last updated
Dec 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Authorized official

Name
Mr. Michael Cornish, PTNPI 1740230341
Title
Manager
Phone
(727) 251-8903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT19198 FL Primary

Addresses

Primary practice location

1501 N Belcher Rd Ste 166
Clearwater, FL 33765-1339

Mailing address

493 Lakeside PL
Largo, FL 33771-1429
Phone (727) 251-8903

Other identifiers 1

IdentifierTypeStateIssuer
014745200MedicaidFL

National Provider Directory

National Provider Directory

Locations

1501 N Belcher Rd
Ste 166
Clearwater, FL 33765
Phone (727) 251-8903

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1386179158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 LAKESIDE PL",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337711429",
            "telephone_number": "727-251-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N BELCHER RD STE 166",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337651339",
            "telephone_number": "727-251-8903",
            "fax_number": "727-216-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T.B.C. VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "CORNISH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "727-251-8903",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014745200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.