Palatka Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PALATKA PHYSICAL THERAPY LLC

Practice address

3715 Crill Ave
Palatka, FL 32177-9168

Phone

(913) 387-0679

Fax

(913) 387-0879

NPI assigned

Aug 14, 2007

Last updated

Apr 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Miles Frisvold, PTNPI 1336230796

Title

Owner/Administrator

Phone

(913) 387-0679

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Miles Frisvold, DPT

  • Physical Therapist
  • Palatka, FL
  • NPI 1336230796
  Medicare reassignment Care Compare group NPD Authorized official
• Kristen N Adams, DPT

  • Physical Therapist
  • Columbia, SC
  • NPI 1770229718

  FL

  Medicare reassignment Care Compare group NPD
• Myah Hennessey

  • Physical Therapy Assistant
  • Palatka, FL
  • NPI 1457161838
  NPD
• Amber Lee Miller

  • Physical Therapy Assistant
  • Palatka, FL
  • NPI 1457030801
  NPD
• Melissa Faye Bowman, PTA

  • Physical Therapy Assistant
  • Palatka, FL
  • NPI 1356657407
  NPD (past)
• Brittany Ann Crane, PTA

  • Physical Therapy Assistant
  • Palatka, FL
  • NPI 1932641958
  NPD (past)
• Natalia Lynn Marquez, PTA

  • Physical Therapy Assistant
  • Palatka, FL
  • NPI 1972214666
  NPD (past)
• Melinda Siehler, LAT, ATC

  • Athletic Trainer
  • Palatka, FL
  • NPI 1992196216
  NPD (past)
• Dennis Scott Silvey, PT

  • Physical Therapist
  • Bella Vista, AR
  • NPI 1255412201
  NPD (past)

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1619169661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779168",
            "telephone_number": "913-387-0679",
            "fax_number": "913-387-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779168",
            "telephone_number": "913-387-0679",
            "fax_number": "913-387-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALATKA PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "FRISVOLD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MILES",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "913-387-0679",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1810605",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "9120138",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irena Maria Pacanowska-Assefa, MD
• Anthony J Pacitti, M.D.
• Alfredo A Pairot, DDS
• Palatka Lpoc, LLC (Vintage Care of Palatka)
• Palatka Nursing and Rehab Op LLC (Radiant Nursing and Rehab at Palatka)
• Palatka SNF Operations LLC (Palatka Center for Rehabilitation and Healing)
• Kiesha Lashawn Parkinson, RN
• Patrick J Harris D O P a
• Larry William Pederson, R.PH., C.PH.
• Mark Peluso, LCSW

• Physical Therapy Clinic/Center in Palatka, FL
• Providers in Palatka, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.