Individual provider Active NPI

Megan E Anderson, ATC

  • Physical Therapist
  • Lakeland, FL
National Provider Identifier
1619309986
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32767 Issued in FL
Practice address
3310 Lakeland Hills Blvd
Lakeland, FL 33805-1974
Phone
(863) 802-6600
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL3591 FL
Physical Therapist 225100000X PT32767 FL Primary

Addresses

Primary practice location

3310 Lakeland Hills Blvd
Lakeland, FL 33805-1974

Mailing address

1879 Grey Fox Dr
Lakeland, FL 33810-2071
Phone (863) 640-1527

Other practice location 1

880 6th St S
St Petersburg, FL 33701-4827
Phone (727) 767-4257

Other practice location 2

880 6th St S
St Petersburg, FL 33701-4827
Phone (727) 767-4257

Other practice location 3

1879 Grey Fox Dr
Lakeland, FL 33810-2071
Phone (863) 640-1527

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

LicenseStateTypeSpecialty
PT32767FLMDPhysical Therapist
AL3591FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1619309986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1879 GREY FOX DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338102071",
            "telephone_number": "863-640-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338051974",
            "telephone_number": "863-802-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 6th St S",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337014827",
            "country_code": "US",
            "telephone_number": "727-767-4257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "880 6th St S",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337014827",
            "country_code": "US",
            "telephone_number": "727-767-4257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1879 Grey Fox Dr",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338102071",
            "country_code": "US",
            "telephone_number": "863-640-1527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MEGAN",
        "middle_name": "E",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3591",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.