Active NPI
Olivia A Reidy
- Physical Therapy Assistant
- Jacksonville Beach, FL
National Provider Identifier
1679407688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA34740
- Practice address
- 1157 Beach Blvd
Jacksonville Beach, FL 32250-3445 - Phone
- (904) 450-5061
- NPI assigned
- Jun 12, 2026
- Sex
- Female
- 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 Therapy Assistant | 225200000X | PTA34740 | FL | Primary |
Addresses
Primary practice location
1157 Beach Blvd
Jacksonville Beach, FL 32250-3445
Mailing address
888 8TH Ave S
Jacksonville, FL 32250-4224
Phone (904) 477-7504
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781222400000",
"number": "1679407688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "888 8TH AVE S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322504224",
"telephone_number": "904-477-7504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1157 BEACH BLVD",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322503445",
"telephone_number": "904-450-5061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIDY",
"first_name": "OLIVIA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-12",
"last_updated": "2026-06-12",
"certification_date": "2026-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA34740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.