Individual provider Active NPI

Cheryl Antoinette Harris, P.T.

  • Physical Therapist
  • Leesburg, FL
National Provider Identifier
1679616189
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0008530 Issued in FL
Practice address
600 W North Blvd
Suite D
Leesburg, FL 34748-5063
Phone
(352) 728-6636
Fax
(352) 787-1324
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0008530 FL Primary

Addresses

Primary practice location

600 W North Blvd
Suite D
Leesburg, FL 34748-5063

Mailing address

4043 Eagles Nest Rd
Fruitland Park, FL 34731-5626
Phone (352) 728-2727

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
0008530FLMDPhysical Therapist

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679616189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 EAGLES NEST RD",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347315626",
            "telephone_number": "352-728-2727",
            "fax_number": "352-728-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W NORTH BLVD",
            "address_2": "SUITE D",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485063",
            "telephone_number": "352-728-6636",
            "fax_number": "352-787-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CHERYL",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "0008530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.