NPIMap

Organization Active NPI

Orthopedic & Sports Physical Therapy Center LLC

  • Physical Therapy Clinic/Center
  • Destin, FL
National Provider Identifier
1386681740
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ORTHOPEDIC & SPORTS PHYSICAL THERAPY CENTER LLC
Practice address
12671 US Highway 98 W
Suite 213
Destin, FL 32550-8304
Phone
(850) 650-4186
Fax
(850) 650-4188
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Authorized official

Name
Ms. Nicole Sheppard
Title
Practice Administrator
Phone
(850) 897-3334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

12671 US Highway 98 W
Suite 213
Destin, FL 32550-8304

Mailing address

12671 US Highway 98 W
Suite 213
Destin, FL 32550-8304
Phone (850) 650-4186

Other identifiers 2

IdentifierTypeStateIssuer
Y906XOtherFLGROUP#
8913153-01MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Orthopedic and Sports Physical Therapy C4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1386681740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12671 US HIGHWAY 98 W",
            "address_2": "SUITE 213",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325508304",
            "telephone_number": "850-650-4186",
            "fax_number": "850-650-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12671 US HIGHWAY 98 W",
            "address_2": "SUITE 213",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325508304",
            "telephone_number": "850-650-4186",
            "fax_number": "850-650-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPORTS PHYSICAL THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "850-897-3334",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP#",
            "identifier": "Y906X",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913153-01",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.