Individual provider Active NPI

James W Corwin, PT

  • Physical Therapist
  • Port Orange, FL
National Provider Identifier
1558405233
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4460 Issued in FL
Practice address
733 Dunlawton Ave
Suite 103
Port Orange, FL 32127-4225
Phone
(386) 756-0077
Fax
(386) 756-6811
NPI assigned
Feb 16, 2007
Last updated
Apr 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4460 FL Primary

Addresses

Primary practice location

733 Dunlawton Ave
Suite 103
Port Orange, FL 32127-4225

Mailing address

733 Dunlawton Ave
Suite 103
Port Orange, FL 32127-4225
Phone (386) 756-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714000647 FL Practitioner - Physical Therapist in Private Practice 2365420973 Reassigns benefits to 1 organization
Practice locations: Port Orange, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Rehabilitation, LLC Physical Therapist CurrentSince Mar 1, 2004 Accepting new patients
Northside Physical Therapy and Rehabilitation, Inc Physical Therapist Past Accepting new patients

Locations

752 W Plymouth Ave
Deland, FL 32720
Phone (376) 734-1136

196 Vining Ct
Ormond Beach, FL 32176
Phone (386) 317-6444

733 Dunlawton Ave
Ste 103
Port Orange, FL 32127
Phone (386) 756-0077

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1558405233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 DUNLAWTON AVE",
            "address_2": "SUITE 103",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274225",
            "telephone_number": "386-756-0077",
            "fax_number": "386-756-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 DUNLAWTON AVE",
            "address_2": "SUITE 103",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274225",
            "telephone_number": "386-756-0077",
            "fax_number": "386-756-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORWIN",
        "first_name": "JAMES",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT4460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.