Ryan Desmarais, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT28692 Issued in FL

Practice address

109 Lake Davenport Blvd
Davenport, FL 33897-9405

Phone

(863) 256-5030

NPI assigned

Jul 11, 2014

Last updated

Jul 11, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Four Corners Chiropractic Centers PA

  • Chiropractor
  • Clermont, FL
  • NPI 1619963147
  NPD (past)

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1679989578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LAKE DAVENPORT BLVD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338979405",
            "telephone_number": "863-256-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LAKE DAVENPORT BLVD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338979405",
            "telephone_number": "863-256-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESMARAIS",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Delgado
• Amy Michelle Deloach, APRN
• Dentists of Davenport, PA (Dentists of Davenport)
• Udaykumar J Desai, B.PHARM
• Jean-Claude Desgranges, M.D.
• Linette Diaz Vizcarrondo
• Isabel Diaz
• Sandra R Diaz
• Rafik Dib, DDS, MSD, PHARMD.
• Tabitha Dieujuste, APRN

• Physical Therapist in Davenport, FL
• Providers in Davenport, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.