Reese Pediatric Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REESE PEDIATRIC PHYSICAL THERAPY, LLC

Practice address

1305 N Bay Dr
Lynn Haven, FL 32444-3205

Phone

(808) 291-3489

Fax

(850) 610-6483

NPI assigned

Jan 5, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Deborah Jean Reese, PT, DPT, MPANPI 1194877944

Title

Owner/Sole Provider

Phone

(808) 291-3489

Specialties & licenses 2

Addresses

Practitioners 1

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

• Deborah Reese

  • Pediatric Physical Therapist
  • Lynn Haven, FL
  • NPI 1194877944
  NPD Authorized official

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1548030943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 N BAY DR",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443205",
            "telephone_number": "808-291-3489",
            "fax_number": "850-610-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N BAY DR",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443205",
            "telephone_number": "808-291-3489",
            "fax_number": "850-610-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REESE PEDIATRIC PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/SOLE PROVIDER",
        "authorized_official_telephone_number": "808-291-3489",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, MPA"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Lynn Haven, FL
• Providers in Lynn Haven, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.