NPIMap

Organization Active NPI

Tallahassee Orthopedic & Sports Physical Therapy

  • Physical Therapist
  • Tallahassee, FL
National Provider Identifier
1558053702
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TALLAHASSEE ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Practice address
2121 W Tennessee St Ste 3
Tallahassee, FL 32304-3118
Phone
(850) 985-9221
Fax
(850) 985-9222
NPI assigned
May 25, 2023
Last updated
May 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Kent C Knisley, DPT, ATC, CLCP
Title
Ceo
Phone
(850) 545-5318

Specialties & licenses 1

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

Addresses

Primary practice location

2121 W Tennessee St Ste 3
Tallahassee, FL 32304-3118

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (502) 537-7804

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040131000346 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3678476017 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Apalachicola, FL; Crawfordville, FL; Tallahassee, FL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Tospt Live Oak10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1558053702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "502-537-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W TENNESSEE ST STE 3",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323043118",
            "telephone_number": "850-985-9221",
            "fax_number": "850-985-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLAHASSEE ORTHOPEDIC & SPORTS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "KNISLEY",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-545-5318",
        "authorized_official_credential": "DPT, ATC, CLCP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.