Ryan Redwine, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT32750 Issued in FL

Practice address

45390 Green Ave
Callahan, FL 32011-3711

Phone

(904) 879-1223

Fax

(904) 879-4986

NPI assigned

Feb 20, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1619477155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 S 14TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343033",
            "telephone_number": "904-277-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45390 GREEN AVE",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320113711",
            "telephone_number": "904-879-1223",
            "fax_number": "904-879-4986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1885 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320343033",
            "country_code": "US",
            "telephone_number": "904-277-4449",
            "fax_number": "904-277-4177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDWINE",
        "first_name": "RYAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Callahan, FL
• Providers in Callahan, 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 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.