Individual provider Active NPI

Courtney Sutherland

  • Physical Therapist
  • Port Orange, FL
National Provider Identifier
1639726177
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT35024 Issued in FL
Practice address
5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321
Phone
(888) 265-2680
NPI assigned
Aug 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305212500 VA
Physical Therapist 225100000X PT35024 FL Primary

Addresses

Primary practice location

5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321

Mailing address

2412 Sterling Point Dr
Portsmouth, VA 23703-4717

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230531003716 FL Practitioner - Physical Therapist in Private Practice 4385001684 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305212500VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc Physical Therapist CurrentSince Mar 1, 2023 Accepting new patients
Empowerme Rehabilitation Florida, LLC Physical Therapist CurrentSince Sep 7, 2023 Accepting new patients
Prosper Therapy Physical Therapist CurrentSince May 1, 2025 Accepting new patients
Visitry Florida LLC Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Mar 1, 2023 Accepting new patients
Empowerme Rehabilitation Florida, LLC CurrentSince Sep 7, 2023 Accepting new patients
Olive Branch Medical LLC PastSince Aug 16, 2025 Accepting new patients

Locations

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

9101 SW 24th St
Miami, FL 33165
Phone (305) 330-6698

35 SE 1st Ave
Ste 200
Ocala, FL 34471
Phone (352) 234-3332

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

802 E Whiting St
Tampa, FL 33602
Phone (716) 523-1783

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 7

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": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1639726177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 STERLING POINT DR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237034717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD STE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288321",
            "telephone_number": "888-265-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212500",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT35024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.