NPIMap

Organization Active NPI

Functional Physical Therapy, LLC

  • Physical Therapist
  • Champions Gate, FL
National Provider Identifier
1649598491
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 21146 Issued in FL
Legal business name
FUNCTIONAL PHYSICAL THERAPY, LLC
Practice address
1310 Island Green St
Champions Gate, FL 33896
Phone
(407) 810-3353
Fax
(407) 386-6733
NPI assigned
May 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Authorized official

Name
Mr. Ulysses Darnell Singleton III, DPT
Title
Owner
Phone
(407) 810-3353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT 21146 FL Primary

Addresses

Primary practice location

1310 Island Green St
Champions Gate, FL 33896

Mailing address

1310 Island Green St
Champions Gate, FL 33896
Phone (407) 810-3353

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1649598491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 ISLAND GREEN ST",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "33896",
            "telephone_number": "407-810-3353",
            "fax_number": "407-386-6733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 ISLAND GREEN ST",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "33896",
            "telephone_number": "407-810-3353",
            "fax_number": "407-386-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "SINGLETON",
        "authorized_official_first_name": "ULYSSES",
        "authorized_official_middle_name": "DARNELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-810-3353",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 21146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champions Gate, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.