Active NPI
Mary Newcomer
- Physical Therapist
- Fort Walton Beach, FL
National Provider Identifier
1588834261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3064
- Practice address
- 928 Mar Walt Dr
Fort Walton Beach, FL 32547-6706 - Phone
- (550) 863-4747
- NPI assigned
- Mar 10, 2008
- Last updated
- Mar 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3064 | FL | Primary |
Addresses
Primary practice location
928 Mar Walt Dr
Fort Walton Beach, FL 32547-6706
Mailing address
928 Mar Walt Dr
Fort Walton Beach, FL 32547-6706
Phone (550) 863-4747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3064 | FL | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1588834261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "928 MAR WALT DR",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476706",
"telephone_number": "550-863-4747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 MAR WALT DR",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476706",
"telephone_number": "550-863-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWCOMER",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "3064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
- Melissa Nelson, MA, LMHC
- Nemours Children's Health, Fort Walton Beach, Specialty Care
- New Heights Counseling & Consulting LLC
- New Hope Village Group Homes LLC
- New Light Counseling & Mediation (Lisa Alvey)
- Devika Newman, DO
- Kathryn Jo Newton, CRNA
- John Quang Nguyen, M.D.
- Justin Nguyen
- Nicole Miller, Pmhnp-BC, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.