NPIMap

Organization Active NPI

Nassau Physical Therapy Inc

  • Specialist
  • Callahan, FL
National Provider Identifier
1487872651
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT 5539 Issued in FL
Legal business name
NASSAU PHYSICAL THERAPY INC
Practice address
45390 Green Ave
Callahan, FL 32011-3711
Phone
(904) 879-1223
Fax
(904) 879-1223
NPI assigned
Apr 23, 2007
Last updated
Nov 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Mrs. Sharon Marino
Title
Office Manager
Phone
(904) 277-4449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT 5539 FL Primary

Addresses

Primary practice location

45390 Green Ave
Callahan, FL 32011-3711

Mailing address

PO Box 1609
Callahan, FL 32011-1609
Phone (904) 879-1223

Other identifiers 2

IdentifierTypeStateIssuer
Y907MOtherFLBLUE CROSS BLUE SHIELD
Y927QOtherFLBLUE CROSS BLUE SHIELD OF FLORIDA

National Provider Directory

National Provider Directory

Locations

45264 Third Ave
Callahan, FL 32011
Phone (904) 879-1223

1885 S 14th St
Fernandina Beach, FL 32034
Phone (904) 261-7878

869 Sadler Rd
Ste 6
Fernandina Beach, FL 32034
Phone (904) 277-4449

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1487872651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1609",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320111609",
            "telephone_number": "904-879-1223",
            "fax_number": "904-879-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45390 GREEN AVE",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320113711",
            "telephone_number": "904-879-1223",
            "fax_number": "904-879-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASSAU PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "MARINO",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-277-4449",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PT 5539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y907M",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "Y927Q",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Callahan, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.