Individual provider Active NPI

Zachary Lindeman

  • Physical Therapist
  • Port Orange, FL
National Provider Identifier
1477064921
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT025521 Issued in PA
Practice address
5535 S Williamson Blvd
Port Orange, FL 32128-8311
Phone
(888) 265-2680
NPI assigned
Oct 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT025521 PA Primary

Addresses

Primary practice location

5535 S Williamson Blvd
Port Orange, FL 32128-8311

Mailing address

813 Martin St
Meadville, PA 16335-1038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181120003298 VA Practitioner - Physical Therapist in Private Practice 1951655372 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Virginia Orthopaedics and Sports MedicineGroup PAC ID 6305742610, 9 clinicians

Practice addresses (Care Compare)

501 Park Hill Dr
Fredericksburg, VA 22401-3377
Phone (540) 372-6737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT025521PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist Current Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 27, 2018 Accepting new patients
Central Virginia Orthopaedics & Sports Medicine Physical Therapist CurrentSince Sep 24, 2020 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 27, 2018 Accepting new patients
Liberty Sports & Physical Therapy LLC CurrentSince Mar 24, 2022 Accepting new patients

Locations

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

501 Park Hill Dr
Fredericksburg, VA 22401
Phone (540) 372-6737

10518 Spotsylvania Ave
#100
Fredericksburg, VA 22408
Phone (540) 710-5341

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1477064921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 MARTIN ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163351038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288311",
            "telephone_number": "888-265-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDEMAN",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT025521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.