NPIMap

Organization Active NPI

Physical Therapy and Rehabiliation Clinic Inc

Doing business as Fleming Island Orthopedic and Sports Physical Therapy

  • Physical Therapist
  • Orange Park, FL
National Provider Identifier
1508929779
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL THERAPY AND REHABILIATION CLINIC INC
Doing business as
Fleming Island Orthopedic and Sports Physical Therapy
Practice address
1835 East West Parkway
16
Orange Park, FL 32003
Phone
(904) 215-3958
Fax
(904) 215-3970
NPI assigned
Dec 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Justin C Weldon, P.T.
Title
Vice-President
Phone
(904) 214-3958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1835 East West Parkway
16
Orange Park, FL 32003

Mailing address

1835 East West Parkway
16
Orange Park, FL 32003
Phone (904) 215-3958

Other names 1

  • Fleming Island Orthopedic and Sports Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Physical Therapy Rehabilitation Clinic Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

4205 Belfort Rd
Ste 1004
Jacksonville, FL 32216
Phone (904) 661-1183

36 S College St
Macclenny, FL 32063
Phone (904) 259-8343

1658 St Vincents Way
Ste 100B
Middleburg, FL 32068
Phone (904) 214-3083

30 Tavernier Dr
Ste A
Ponte Vedra, FL 32081
Phone (904) 686-9929

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508929779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 EAST WEST PARKWAY",
            "address_2": "16",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-215-3958",
            "fax_number": "904-215-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 EAST WEST PARKWAY",
            "address_2": "16",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-215-3958",
            "fax_number": "904-215-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AND REHABILIATION CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WELDON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "904-214-3958",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fleming Island Orthopedic and Sports Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.