Organization Active NPI

In Balance Physical Therapy

  • Physical Therapy Clinic/Center
  • St Augustine, FL
National Provider Identifier
1457049231
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
IN BALANCE PHYSICAL THERAPY
Practice address
84 Theatre Dr Ste 500
St Augustine, FL 32086-3131
Phone
(904) 770-2552
NPI assigned
Apr 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Authorized official

Name
Joseph R Verna, DC
Title
Administrator
Phone
(484) 459-0780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

84 Theatre Dr Ste 500
St Augustine, FL 32086-3131

Mailing address

84 Theatre Dr Ste 500
St Augustine, FL 32086-3131
Phone (904) 770-2552

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230725004232 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254792112 Receives reassigned benefits from 1 practitioner
Practice locations: St Augustine, FL

National Provider Directory

National Provider Directory

Locations

84 Theatre Dr
Ste 500
St Augustine, FL 32086
Phone (904) 222-6440

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1457049231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 THEATRE DR STE 500",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863131",
            "telephone_number": "904-770-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 THEATRE DR STE 500",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863131",
            "telephone_number": "904-770-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN BALANCE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "VERNA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "484-459-0780",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.