Deborah Vonbrocken, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA1155 Issued in FL

Practice address

190 Rodeo Rd
Ormond Beach, FL 32174-7928

Phone

(386) 295-4493

Fax

(386) 446-7777

NPI assigned

Aug 20, 2012

Last updated

Aug 20, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1568710796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 RODEO RD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321747928",
            "telephone_number": "386-295-4493",
            "fax_number": "386-446-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 RODEO RD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321747928",
            "telephone_number": "386-295-4493",
            "fax_number": "386-446-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONBROCKEN",
        "first_name": "DEBORAH",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA1155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PTA1155",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.