Individual provider Active NPI

Bruce L. Snow, PT

  • Physical Therapist
  • Delray Beach, FL
National Provider Identifier
1417078486
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 18536 Issued in FL
Practice address
16200 Jog Rd
Delray Beach, FL 33446-2321
Phone
(561) 638-0000
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 18536 FL Primary
Physical Therapist 225100000X 3981 SC
Physical Therapist 225100000X 40QA01206700 NJ
Physical Therapist 225100000X 11-03670 KS

Addresses

Primary practice location

16200 Jog Rd
Delray Beach, FL 33446-2321

Mailing address

14494 Peace River Way
West Palm Beach, FL 33418-8680
Phone (803) 727-5026

Other identifiers 1

IdentifierTypeStateIssuer
TH1029MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT 18536FLMDPhysical Therapist
11-03670KSMDPhysical Therapist
40QA01206700NJMDPhysical Therapist
3981SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417078486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14494 PEACE RIVER WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334188680",
            "telephone_number": "803-727-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16200 JOG RD",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334462321",
            "telephone_number": "561-638-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "BRUCE",
        "middle_name": "L.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 18536",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "3981",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01206700",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03670",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH1029",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.