Organization Active NPI

Smart Body Physical Therapy Inc

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1396767018
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SMART BODY PHYSICAL THERAPY INC
Practice address
12421 San Jose Blvd Ste 100a
Jacksonville, FL 32223-2680
Phone
(904) 296-4140
Fax
(904) 279-0963
NPI assigned
Jul 24, 2006
Last updated
Aug 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Authorized official

Name
Laura Bunso, PTNPI 1053502393
Title
President
Phone
(904) 382-3804

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

12421 San Jose Blvd Ste 100a
Jacksonville, FL 32223-2680

Mailing address

10950 60 San Jose Blvd 196
Jacksonville, FL 32223
Phone (904) 296-4140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050414001073 FL Part B Supplier - Clinic/Group Practice 0648217240 Receives reassigned benefits from 11 practitioners
Practice locations: Jacksonville, FL; St Augustine, FL; Ponte Vedra, FL

National Provider Directory

National Provider Directory
Tax ID family
Smart Body Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

6885 Belfort Oaks Pl
Ste 305
Jacksonville, FL 32216
Phone (904) 296-4140

10950 San Jose Blvd
#196
Jacksonville, FL 32223

12421 San Jose Blvd
Ste 100A
Jacksonville, FL 32223
Phone (904) 296-4140

6639 Southpoint Pkwy
Ste 103
Jacksonville, FL 32216
Phone (904) 296-4140

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1396767018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10950 60 SAN JOSE BLVD 196",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-296-4140",
            "fax_number": "904-279-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12421 SAN JOSE BLVD STE 100A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232680",
            "telephone_number": "904-296-4140",
            "fax_number": "904-279-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART BODY PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "BUNSO",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-382-3804",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.