Active NPI
Jarrett William Stark, PT, DPT
- Physical Therapist
- Tampa, FL
National Provider Identifier
1437815917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT37974
- Practice address
- 3820 Northdale Blvd Ste 101a
Tampa, FL 33624-1834 - Phone
- (813) 264-7734
- NPI assigned
- Nov 9, 2021
- Sex
- Male
- 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 Therapist | 225100000X | PT37974 | FL | Primary |
Addresses
Primary practice location
3820 Northdale Blvd Ste 101a
Tampa, FL 33624-1834
Mailing address
25145 Tussock Way Apt 102
Lutz, FL 33559-8729
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 |
|---|---|---|---|
| PT37974 | FL | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1437815917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25145 TUSSOCK WAY APT 102",
"city": "LUTZ",
"state": "FL",
"postal_code": "335598729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3820 NORTHDALE BLVD STE 101A",
"city": "TAMPA",
"state": "FL",
"postal_code": "336241834",
"telephone_number": "813-264-7734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "JARRETT",
"middle_name": "WILLIAM",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-09",
"last_updated": "2021-11-09",
"certification_date": "2021-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT37974",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.