Individual provider Active NPI

Randi Mitchell Incardona, PT

  • Specialist
  • Sarasota, FL
National Provider Identifier
1649482613
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT00004610 Issued in FL
Practice address
3943 Clark Rd
Sarasota, FL 34233-2364
Phone
(941) 926-3363
Fax
(941) 926-3342
NPI assigned
May 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT00004610 FL Primary

Addresses

Primary practice location

3943 Clark Rd
Sarasota, FL 34233-2364

Mailing address

PO Box 19227
Sarasota, FL 34276-2227
Phone (941) 926-3363

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00004610FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Club 50, LLC PastSince Feb 4, 2015 Accepting new patients
Venice Rehab, LLC Past Accepting new patients
Rehabfirst Inc PastSince Mar 1, 2002 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649482613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19227",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342762227",
            "telephone_number": "941-926-3363",
            "fax_number": "941-926-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3943 CLARK RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332364",
            "telephone_number": "941-926-3363",
            "fax_number": "941-926-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INCARDONA",
        "first_name": "RANDI",
        "middle_name": "MITCHELL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PT00004610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.