Individual provider Active NPI

Andrew Kawamleh

  • Physical Therapy Assistant
  • St Augustine, FL
National Provider Identifier
1538636709
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA28978 Issued in FL
Practice address
150 Mariner Health Way
St Augustine, FL 32086-3215
Phone
(904) 794-9988
NPI assigned
Oct 25, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA28978 FL Primary

Addresses

Primary practice location

150 Mariner Health Way
St Augustine, FL 32086-3215

Mailing address

10000 Gate Pkwy N Apt 1625
Jacksonville, FL 32246-8216
Phone (904) 708-2024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1538636709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 GATE PKWY N APT 1625",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468216",
            "telephone_number": "904-708-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MARINER HEALTH WAY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863215",
            "telephone_number": "904-794-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWAMLEH",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-25",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA28978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; 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.