Individual provider Active NPI

Brian Lee Ackerman, P.T.

  • Physical Therapist
  • Seminole, FL
National Provider Identifier
1467527101
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT23549 Issued in FL
Practice address
10099 Seminole Blvd
Suite 5a
Seminole, FL 33772-2521
Phone
(727) 399-8226
Fax
(727) 393-4823
NPI assigned
Nov 21, 2006
Last updated
Jul 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5225 OH
Physical Therapist 225100000X PT23549 FL Primary

Addresses

Primary practice location

10099 Seminole Blvd
Suite 5a
Seminole, FL 33772-2521

Mailing address

2602 58TH St S
Gulfport, FL 33707-5257
Phone (419) 351-5423

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
PT23549FLMDPhysical Therapist
5225OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports and Orthopedic Rehabilitation Services Inc Past Accepting new patients
Kozak P T & Assoc Inc Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1467527101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 58TH ST S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337075257",
            "telephone_number": "419-351-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10099 SEMINOLE BLVD",
            "address_2": "SUITE 5A",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337722521",
            "telephone_number": "727-399-8226",
            "fax_number": "727-393-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "BRIAN",
        "middle_name": "LEE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "5225",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT23549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.