Individual provider Active NPI

Joanne G Sinclair, PTA

  • Physical Therapy Assistant
  • Lutz, FL
National Provider Identifier
1467576074
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 19293 Issued in FL
Practice address
414 Chapman Rd E
Lutz, FL 33549-5779
Phone
(813) 948-0612
Fax
(813) 909-2872
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 19293 FL Primary

Addresses

Primary practice location

414 Chapman Rd E
Lutz, FL 33549-5779

Mailing address

5930 Phoebenest Dr
Lithia, FL 33547-1786
Phone (813) 571-0831

Other identifiers 2

IdentifierTypeStateIssuer
BBJL6PKAOtherFLAETNA HEALTH INS.
PTA 19293OtherFLPHYSICAL THERAPIST ASST

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
PTA 19293FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467576074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5930 PHOEBENEST DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335471786",
            "telephone_number": "813-571-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 CHAPMAN RD E",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335495779",
            "telephone_number": "813-948-0612",
            "fax_number": "813-909-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINCLAIR",
        "first_name": "JOANNE",
        "middle_name": "G",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 19293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH INS.",
            "identifier": "BBJL6PKA",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASST",
            "identifier": "PTA 19293",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.