Individual provider Active NPI

Nathaniel Tyler Kephart, DPT

  • Physical Therapist
  • Saint Petersburg, FL
National Provider Identifier
1487081493
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT34598 Issued in FL
Practice address
6775 40TH Ave N
Saint Petersburg, FL 33709-4939
Phone
(727) 803-1102
NPI assigned
Oct 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT003225 WV
Physical Therapist 225100000X PT34598 FL Primary

Addresses

Primary practice location

6775 40TH Ave N
Saint Petersburg, FL 33709-4939

Mailing address

260 1St Ave S Ste 200
Saint Petersburg, FL 33701-4364
Phone (727) 308-9848

Other practice location 1

1076 Ribaut Rd
Suite 102
Beaufort, SC 29902-5476
Phone (843) 521-1970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131211001581 SC Practitioner - Physical Therapist in Private Practice 2163659442 Reassigns benefits to 1 organization
I20190701000198 FL Practitioner - Physical Therapist in Private Practice 2163659442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visitry Florida LLCGroup PAC ID 4688016272, 27 clinicians

Practice addresses (Care Compare)

802 E Whiting St
Tampa, FL 33602-4136
Phone (716) 523-1783

Merit-based Incentive Payment System (MIPS)

Final score
58.53 of 100Reported as group
Quality
0
Promoting interoperability
95
Improvement activities
40
Cost
65.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT003225WVMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince Mar 23, 2022 Accepting new patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince Mar 23, 2022 Accepting new patients
Visitry Florida LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Advanced Medical of Florida LLC Physical Therapist PastSince Dec 1, 2023 Accepting new patients
Palmetto Therapy Services Physical Therapist PastSince Sep 14, 2015 Accepting new patients

Locations

802 E Whiting St
Tampa, FL 33602
Phone (716) 523-1783

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

2333 Ashley River Rd
Charleston, SC 29414
Phone (843) 258-5538

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24544/brand/1/csg/1/fhir/r4

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": "1380844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1487081493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 1ST AVE S STE 200",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014364",
            "telephone_number": "727-308-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6775 40TH AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337094939",
            "telephone_number": "727-803-1102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1076 Ribaut Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Beaufort",
            "state": "SC",
            "postal_code": "299025476",
            "country_code": "US",
            "telephone_number": "843-521-1970",
            "fax_number": "843-521-0908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEPHART",
        "first_name": "NATHANIEL",
        "middle_name": "TYLER",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WV",
            "license": "PT003225",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.