NPIMap

Organization Active NPI

Atlas Physical Therapy & Sports Medicine Inc

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1508859893
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8402 Issued in FL
Legal business name
ATLAS PHYSICAL THERAPY & SPORTS MEDICINE INC
Practice address
12421 San Jose Blvd
Ste 100
Jacksonville, FL 32223-2680
Phone
(904) 292-0195
Fax
(904) 292-0566
NPI assigned
Aug 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Authorized official

Name
Mr. Adam M Schoenberg, PT ATCNPI 1982631461
Title
Owner
Phone
(904) 292-0195

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT8402 FL Primary

Addresses

Primary practice location

12421 San Jose Blvd
Ste 100
Jacksonville, FL 32223-2680

Mailing address

12421 San Jose Blvd
Ste 100
Jacksonville, FL 32223-2680
Phone (904) 292-0195

Other identifiers 2

IdentifierTypeStateIssuer
7865018OtherAETNA
1699778001OtherCIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041011000295 FL Part B Supplier - Clinic/Group Practice 8426017807 Receives reassigned benefits from 14 practitioners
Practice locations: Jacksonville, FL; St Augustine, FL

National Provider Directory

National Provider Directory
Tax ID family
Atlas Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

880 A1A N
Ste 6
Ponte Vedra Beach, FL 32082
Phone (904) 292-0195

165 Hampton Point Dr
Ste 3
Saint Augustine, FL 32092
Phone (904) 429-0290

425 W Town Pl
Ste 102
St Augustine, FL 32092
Phone (904) 292-0195

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1508859893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12421 SAN JOSE BLVD",
            "address_2": "STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232680",
            "telephone_number": "904-292-0195",
            "fax_number": "904-292-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12421 SAN JOSE BLVD",
            "address_2": "STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232680",
            "telephone_number": "904-292-0195",
            "fax_number": "904-292-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS PHYSICAL THERAPY & SPORTS MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "SCHOENBERG",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-292-0195",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT8402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7865018",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1699778001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.