NPIMap

Organization Active NPI

Westchase Physical Therapy & Medical Supply, LLC

  • Rehabilitation Clinic/Center
  • Lutz, FL
National Provider Identifier
1508176868
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
HCC5810 Issued in FL
Legal business name
WESTCHASE PHYSICAL THERAPY & MEDICAL SUPPLY, LLC
Practice address
4969 Van Dyke Rd
Lutz, FL 33558-4813
Phone
(813) 443-4716
Fax
(813) 443-4720
NPI assigned
Oct 20, 2010
Last updated
Oct 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Authorized official

Name
Mr. Brian Patrick Creadon, OTR/L
Title
President/Owner
Phone
(813) 434-3960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X HCC5810 FL Primary

Addresses

Primary practice location

4969 Van Dyke Rd
Lutz, FL 33558-4813

Mailing address

12625 Race Track Rd
Tampa, FL 33626-1331
Phone (813) 343-3960

National Provider Directory

National Provider Directory
Tax ID family
Westchase Physical Therapy Medical Supply LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1508176868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 RACE TRACK RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261331",
            "telephone_number": "813-343-3960",
            "fax_number": "813-343-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4969 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584813",
            "telephone_number": "813-443-4716",
            "fax_number": "813-443-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTCHASE PHYSICAL THERAPY & MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "CREADON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "813-434-3960",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "FL",
            "license": "HCC5810",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 20, 2010; 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.