Emily Benn, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

30857 Issued in FL

Practice address

4689 Hwy 17
Suite 11
Fleming Island, FL 32003

Phone

(904) 375-9753

Fax

(904) 375-8380

NPI assigned

Nov 16, 2015

Sex

Female

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

• Emily Debra McKinnon Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Augustine Rehabilitation Specialists LLCGroup PAC ID 8426107293, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saint Augustine Rehabilitation Specialists LLC

  • Physical Therapist
  • St Augustine, FL
  • NPI 1548407521
  Medicare reassignment Care Compare group NPD
• FM Medical Inc

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1588091029
  Medicare reassignment NPD
• Hughston Orthopaedic Southeast PC

  • Orthopaedic Surgery Physician
  • Columbus, GA
  • NPI 1568914026

  FL

  Medicare reassignment NPD
• FM Medical Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • St Augustine, FL
  • NPI 1053790246
  NPD
• Hughston Orthopaedic Southeast PC

  • Durable Medical Equipment & Medical Supplies
  • Deland, FL
  • NPI 1659068377
  NPD

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1396119301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "fax_number": "706-494-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4689 HWY 17",
            "address_2": "SUITE 11",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-375-9753",
            "fax_number": "904-375-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENN",
        "first_name": "EMILY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "30857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "MCKINNON",
            "middle_name": "DEBRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.