Individual provider Active NPI

Justin McKinney, P.T.

  • Physical Therapist
  • Boca Raton, FL
National Provider Identifier
1629245378
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7424 Issued in NC
Practice address
5901 Broken Sound Pkwy
Ste. 500
Boca Raton, FL 33487-2773
Phone
(561) 367-1175
NPI assigned
May 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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 7424 NC Primary

Addresses

Primary practice location

5901 Broken Sound Pkwy
Ste. 500
Boca Raton, FL 33487-2773

Mailing address

PO Box 367
Herkimer, NY 13350-0367

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131217000555 AZ Practitioner - Physical Therapist in Private Practice 9638306715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Backways Physical Therapy, PLLCGroup PAC ID 6709856917, 8 clinicians

Practice addresses (Care Compare)

250 S McCormick St
Prescott, AZ 86303-4714
Phone (928) 777-8050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Backways Physical Therapy, PLLC Physical Therapist CurrentSince Nov 1, 2013 Accepting new patients

Locations

250 S McCormick St
Prescott, AZ 86303
Phone (928) 710-6079

Organizations & group practices 1

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": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1629245378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133500367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 BROKEN SOUND PKWY",
            "address_2": "STE. 500",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872773",
            "telephone_number": "561-367-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "JUSTIN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "7424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.