Excellence Physical Therapy LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EXCELLENCE PHYSICAL THERAPY LLC

Practice address

2211 S Highway 77 Ste 201
Lynn Haven, FL 32444-4641

Phone

(850) 252-1414

NPI assigned

Mar 18, 2020

Last updated

Mar 18, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rati Poriya, PTNPI 1861853459

Title

Owner

Phone

(281) 908-6480

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rati Poriya, PT

  • Physical Therapist
  • Lynn Haven, FL
  • NPI 1861853459
  Medicare reassignment Care Compare group NPD Authorized official
• Heidi S Rosasco, PT

  • Physical Therapist
  • Port St Joe, FL
  • NPI 1750120432
  Medicare reassignment Care Compare group
• Joanne Annette Hart, PTA

  • Physical Therapy Assistant
  • Lynn Haven, FL
  • NPI 1447853643
  NPD
• Brian R Davison, PTA

  • Physical Therapy Assistant
  • Lynn Haven, FL
  • NPI 1992375349
  NPD (past)
• Lori L Deaton, PTA

  • Physical Therapy Assistant
  • Lynn Haven, FL
  • NPI 1891372496
  NPD (past)
• Vincenza White

  • Physical Therapy Assistant
  • Lynn Haven, FL
  • NPI 1245940147
  NPD (past)

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1679109953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 S HIGHWAY 77 STE 201",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324444641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 S HIGHWAY 77 STE 201",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324444641",
            "telephone_number": "850-252-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENCE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "PORIYA",
        "authorized_official_first_name": "RATI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-908-6480",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerald Coast Rheumatology LLC
• Emerald Coast Walk in Clinic LLC
• Emerald Shores Chiropractic LLC
• Frederick B Epstein, M.D.
• Jinan Erchid
• Helen D Ezelll, LPN, BA
• F. Reese Harrison, DMD, PA
• Carlos Humberto Fernandez, PA-C
• Ashley Ann Ferrell, MSN, APRN, FNP-C
• Erika J Finch, MSW

• Clinic/Center in Lynn Haven, FL
• Providers in Lynn Haven, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.

Verify at the official NPI Registry.