Active NPI
Jennifer Everland, PTA
- Physical Therapy Assistant
- Eustis, FL
National Provider Identifier
1417269499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA 22138
- Practice address
- 301 S Bay St
Eustis, FL 32726-4005 - Phone
- (352) 357-7767
- NPI assigned
- Jul 8, 2010
- Last updated
- Jul 8, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA 22138 | FL | Primary |
Addresses
Primary practice location
301 S Bay St
Eustis, FL 32726-4005
Mailing address
92 Pine Forest PL
Apopka, FL 32712-2768
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA 22138 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278547200000",
"number": "1417269499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92 PINE FOREST PL",
"city": "APOPKA",
"state": "FL",
"postal_code": "327122768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S BAY ST",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327264005",
"telephone_number": "352-357-7767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERLAND",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-08",
"last_updated": "2010-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA 22138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eustis, FL
- Larhonda Marie Enslow, APRN
- Eustis Family Dental Spa, LLC
- Eustis Family Medicine
- Eustis Senior Care Inc (Eustis Senior Care)
- Kimberly Ann Evans, RN
- Excel Hospitality Group, LLC (Regency Park Assisted Living)
- Rebecca Anne Fallucca Fails, DPT
- Family Care on Eustis Square PA
- Flor Farinas, LMHC
- Amanda Jo Farley, M.ED, BCBA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.