Individual provider Active NPI

Jacob Workinger

  • Physical Therapy Assistant
  • Seminole, FL
National Provider Identifier
1659840940
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
29002 Issued in FL
Practice address
11224 Park Blvd
Seminole, FL 33772-4752
Phone
(727) 394-0949
NPI assigned
Nov 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 29002 FL Primary

Addresses

Primary practice location

11224 Park Blvd
Seminole, FL 33772-4752

Mailing address

4566 62ND St N
Kenneth City, FL 33709-5008

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29002FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1659840940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 62ND ST N",
            "city": "KENNETH CITY",
            "state": "FL",
            "postal_code": "337095008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11224 PARK BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724752",
            "telephone_number": "727-394-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORKINGER",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "29002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.