Thomas Bradley Vickers, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT37213 Issued in FL

Practice address

1852 SW Barnett Way Ste 101
Lake City, FL 32025-6953

Phone

(386) 752-7332

NPI assigned

Apr 2, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Physical Therapy and Rehabiliation Clinic Inc

  dba Fleming Island Orthopedic and Sports Physical Therapy

  • Physical Therapist
  • Orange Park, FL
  • NPI 1508929779
  NPD (past)
• Atlas Physical Therapy LLC

  • Occupational Therapist
  • Paducah, KY
  • NPI 1518330497
  NPD (past)

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1568924348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11911 CORNELIUS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464004",
            "telephone_number": "904-234-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 SW BARNETT WAY STE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256953",
            "telephone_number": "386-752-7332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11911 Cornelius St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322464004",
            "country_code": "US",
            "telephone_number": "904-234-4446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1658 St Vincents Way Ste 100B",
            "address_purpose": "LOCATION",
            "city": "Middleburg",
            "state": "FL",
            "postal_code": "320688459",
            "country_code": "US",
            "telephone_number": "904-214-3313",
            "fax_number": "904-406-0913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "THOMAS",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "DPT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214533",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "008502",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10947",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4563",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT37213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WebPT",
            "affiliation": "N",
            "address_1": "1658 St Vincents Way Ste 100B",
            "city": "Middleburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320688459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abimael Velez
• Jessica Velez, LMHC
• Vernon Montoya MD PA
• Veterans Affairs
• Veterans Health Administration
• Laura Viksnins, CPNP-PC
• Andres R Villar, MD
• Tanecia L Virgil
• Sanjeet Kaur Virk, O.D
• Margaret Adine Vodnansky, PT

• Physical Therapist in Lake City, FL
• Providers in Lake City, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.