Phpts of Ormond Beach, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PHPTS OF ORMOND BEACH, LLC

Doing business as

5Palms

Practice address

515 Tomoka Ave
Ormond Beach, FL 32174-6133

Phone

(281) 506-0831

NPI assigned

Jan 24, 2017

Organization subpart

No

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

Authorized official

Name

Scott M. Sasserson

Title

Chief Executive Officer

Phone

(931) 994-8001

Specialties & licenses 2

Addresses

Other names 1

• 5Palms Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1457898744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207983",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207983",
            "telephone_number": "281-506-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 TOMOKA AVE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746133",
            "telephone_number": "281-506-0831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 W Granada Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321748157",
            "country_code": "US",
            "telephone_number": "386-506-8110",
            "fax_number": "386-463-2170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHPTS OF ORMOND BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-24",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "SASSERSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "931-994-8001"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "5Palms",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "5Palms",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vito Aniello Petrozzino, M.D.
• Tamara Fields Pettit, MS, LMFT
• Lorenzo Tien Phan, L.AC
• Pharaohs Trading L.L.C. (Dental and Medical Supplies)
• Terri Phoenix, M.ED., LPC, NCC
• Physicians Ambulatory Surgery Center Inc
• Charles Lawrence Piazza Jr., DPT, ATC, MTC
• Jill Anne Piazza, PT
• Emmalynn I Pier, LMT
• Meg Pierce, PA

• Substance Abuse Rehabilitation Facility in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.