Individual provider Active NPI

Justin Andrew Zych, PT, DPT

  • Physical Therapist
  • Ponte Vedra Beach, FL
National Provider Identifier
1588044135
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30338 Issued in FL
Practice address
816 A1A N Ste 307
Ponte Vedra Beach, FL 32082-3219
Phone
(904) 543-4021
NPI assigned
Jun 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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 30338 FL Primary

Addresses

Primary practice location

816 A1A N Ste 307
Ponte Vedra Beach, FL 32082-3219

Mailing address

1655 The Greens Way Apt 3124
Jacksonville Beach, FL 32250-2466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181207001270 GA Practitioner - Physical Therapist in Private Practice 5193069730 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30338FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Aug 28, 2018 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Emory Physical Therapy, LLC CurrentSince Aug 28, 2018 Accepting new patients

Locations

1845 Satellite Blvd
Ste 600
Duluth, GA 30097
Phone (404) 778-6490

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

8259 Wicker Ave
Saint John, IN 46373
Phone (219) 365-6560

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1588044135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 THE GREENS WAY APT 3124",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 A1A N STE 307",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823219",
            "telephone_number": "904-543-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYCH",
        "first_name": "JUSTIN",
        "middle_name": "ANDREW",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "30338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.