Monticello Physical Therapy & Wellness

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MONTICELLO PHYSICAL THERAPY & WELLNESS

Practice address

195 E Dogwood St
Monticello, FL 32344-1928

Phone

(850) 321-4443

Fax

(850) 378-4530

NPI assigned

Aug 31, 2022

Organization subpart

No

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

Authorized official

Name

John Marcus Roberts, PT, DPT

Title

MGR, Ambr

Phone

(850) 321-4443

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Camryn Jackson, PT, DPT

  • Physical Therapist
  • Monticello, FL
  • NPI 1295612927
  Medicare reassignment NPD
• Marcus Roberts, PT, DPT

  • Physical Therapist
  • Thomasville, GA
  • NPI 1003460015

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1578283453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6492 WAUKEENAH HWY",
            "city": "MONTICELLO",
            "state": "FL",
            "postal_code": "323441190",
            "telephone_number": "850-321-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 E DOGWOOD ST",
            "city": "MONTICELLO",
            "state": "FL",
            "postal_code": "323441928",
            "telephone_number": "850-321-4443",
            "fax_number": "850-378-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO PHYSICAL THERAPY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-31",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARCUS",
        "authorized_official_title_or_position": "MGR, AMBR",
        "authorized_official_telephone_number": "850-321-4443",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monticello Dentistry PLLC
• Monticello Gardens LLC
• Monticello HLTH MGMT LLC
• Monticello Opco LLC
• Monticello Partnership LTD
• Crystal Elizabeth Moody
• Adin Matthew Mora Velazquez Jr.
• Myeyedr Optometry of Florida, LLC
• Myobalance Clinical Massage and Manual Therapy LLC
• Latoya Nicole Nealy

• Physical Therapist in Monticello, FL
• Providers in Monticello, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.