Active NPI
Leonard William Gomez, DPT, ATC
- Orthopedic Physical Therapist
- Midland, MI
National Provider Identifier
1669768347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT26461
- Practice address
- 130 W Campbell CT
Midland, MI 48642-3634 - Phone
- (321) 947-1577
- NPI assigned
- Jun 22, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL 2669 | FL | |
| Orthopedic Physical Therapist | 2251X0800X | PT26461 | FL | Primary |
Addresses
Primary practice location
130 W Campbell CT
Midland, MI 48642-3634
Mailing address
130 W Campbell CT
Midland, MI 48642-3634
Other practice location 1
4809 N Armenia Ave
Suite 200
Tampa, FL 33603-1447
Phone (813) 877-1930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT26461 | FL | MD | Orthopedic Physical Therapist |
| AL 2669 | FL | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reinvent Health Inc | Orthopedic | Current | Accepting new patients |
| Prava PC | Orthopedic | Current | Accepting new patients |
Locations
900 Trail Ridge Rd
Fl 1
Aiken, SC 29803
Phone (803) 233-2882
900 Trail Ridge Rd
Ste 101
Aiken, SC 29803
Phone (405) 821-6648
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 and National Provider Directory roles.
-
- Physical Therapist
- Bluffton, SC
- NPI 1073957064
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1669768347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 W CAMPBELL CT",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486423634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 W CAMPBELL CT",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486423634",
"telephone_number": "321-947-1577"
}
],
"practiceLocations": [
{
"address_1": "4809 N Armenia Ave",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336031447",
"country_code": "US",
"telephone_number": "813-877-1930",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOMEZ",
"first_name": "LEONARD",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "DPT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-22",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL 2669",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "FL",
"license": "PT26461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.