Active NPI
Raheem M Skinner, PT
- Physical Therapist
- Jacksonville, FL
National Provider Identifier
1679375489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT42854
- Practice address
- 484 Riverside Ave
Jacksonville, FL 32202-4912 - Phone
- (904) 579-2824
- NPI assigned
- Mar 25, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT42854 | FL | Primary |
Addresses
Primary practice location
484 Riverside Ave
Jacksonville, FL 32202-4912
Mailing address
PO Box 932184
Atlanta, GA 31193-2184
Phone (566) 783-4848
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT42854 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742860800000",
"number": "1679375489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 932184",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311932184",
"telephone_number": "566-783-4848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "484 RIVERSIDE AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322024912",
"telephone_number": "904-579-2824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKINNER",
"first_name": "RAHEEM",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-25",
"last_updated": "2025-03-25",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT42854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
- Skin Glow Beauty Studio LLC
- Skin Revive Massage and Spa, LLC
- Emily Victoria Skinner
- Freida Ruth Skinner, OTD., OTR/L
- Quawendella Baejuhne Skinner, ARNP
- Stephanie Lashae Skinner, LMHC
- Hannah Lynn Skipper, PHARMD
- Stephen Aaron Skipper, DPT
- Tracy Todd Skipton, M.D.
- Scott Roberts Sklenicka, D.M.D., M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.