NPIMap

Organization Active NPI

In Motion Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1679760862
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
IN MOTION PHYSICAL THERAPY LLC
Practice address
4776 Hodges Blvd
Suite 101
Jacksonville, FL 32224-7217
Phone
(904) 223-2363
Fax
(904) 223-2365
NPI assigned
Oct 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Authorized official

Name
John K Wiest
Title
Owner
Phone
(904) 671-0255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

4776 Hodges Blvd
Suite 101
Jacksonville, FL 32224-7217

Mailing address

4776 Hodges Blvd
Suite 101
Jacksonville, FL 32224-7217
Phone (904) 223-2363

Other practice location 1

559 W Twincourt Trl Unit 610
St Augustine, FL 32095-8805
Phone (904) 223-2363

Other names 1

  • Fyzical Therapy & Balance Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080310000487 FL Part B Supplier - Clinic/Group Practice 9830274240 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Jacksonville, FL; St Augustine, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4776 Hodges Blvd
Ste 101
Jacksonville, FL 32224
Phone (904) 223-2363

4776 Hodges Blvd
Jacksonville, FL 32224

559 W Twincourt Trl
Ste 607608
Saint Augustine, FL 32095
Phone (904) 230-3006

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1679760862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4776 HODGES BLVD",
            "address_2": "SUITE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247217",
            "telephone_number": "904-223-2363",
            "fax_number": "904-223-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4776 HODGES BLVD",
            "address_2": "SUITE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247217",
            "telephone_number": "904-223-2363",
            "fax_number": "904-223-2365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "559 W Twincourt Trl Unit 610",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320958805",
            "country_code": "US",
            "telephone_number": "904-223-2363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IN MOTION PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "WIEST",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-671-0255"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Therapy & Balance Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.