Individual provider Active NPI

Robertus Veldwijk, PHYSICAL THERAPIST

  • Physical Therapist
  • Crystal River, FL
National Provider Identifier
1659598654
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0006347 Issued in FL
Practice address
6043 W. Nordling Loop
Crystal River, FL 34429
Phone
(352) 563-0030
Fax
(352) 563-0102
NPI assigned
Apr 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
Physical Therapist 225100000X PT0006347 FL Primary

Addresses

Primary practice location

6043 W. Nordling Loop
Crystal River, FL 34429

Mailing address

6043 W. Nordling Loop
Crystal River, FL 34429
Phone (352) 563-0030

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
PT0006347FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cora Health Services, Inc PastSince Jan 25, 2016 Accepting new patients

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, 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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659598654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6043 W. NORDLING LOOP",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34429",
            "telephone_number": "352-563-0030",
            "fax_number": "352-563-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6043 W. NORDLING LOOP",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34429",
            "telephone_number": "352-563-0030",
            "fax_number": "352-563-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELDWIJK",
        "first_name": "ROBERTUS",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT0006347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal River, 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.