Tallahassee Orthopedic & Sports Physical Therapy
Organization Active NPI Physical Therapist · Tallahassee, FL
NPI 1558053702 · NPPES record last updated May 25, 2023
Key facts
- NPI
- 1558053702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 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
- Organization subpart
- No
Authorized official
- Name
- Kent C Knisley, DPT, ATC, CLCP
- Title
- Ceo
- Phone
- (850) 545-5318
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 9
Practitioners 4
-
Fiji Ann Moyer, PT, DPT
-
Kayla Severance, DPT
-
Ethan Wilson, PT, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Tallahassee Orthopedic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
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
Other providers in Tallahassee, FL
- Tallahassee Occupational Therapy & Adaptive Living Solutions
- Tallahassee Oral and Maxillofacial Surgery, PLLC
- Tallahassee Orthopaedic Surgery Partners LTD
- Tallahassee Orthopaedic Surgery Partners LTD
- Tallahassee Orthopedic & Sports Physical Therapy
- Tallahassee Orthopedic & Sports Physical Therapy
- Tallahassee Orthopedic & Sports Physical Therapy
- Tallahassee Orthopedic & Sports Physical Therapy
- Tallahassee Orthopedic & Sports Physical Therapy, Inc,
- Tallahassee Orthopedic & Sports Physical Therapy, LLC
All providers in Tallahassee, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.