Active NPI
Todd McKenna
- Physical Therapy Assistant
- Tarpon Springs, FL
National Provider Identifier
1689324865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA26076
- Practice address
- 515 Chesapeake Dr
Tarpon Springs, FL 34689-2515 - Phone
- (727) 934-4629
- NPI assigned
- Mar 28, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | PTA26076 | FL | Primary |
Addresses
Primary practice location
515 Chesapeake Dr
Tarpon Springs, FL 34689-2515
Mailing address
23240 Brandy Rd
Land O Lakes, FL 34639-2709
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 |
|---|---|---|---|
| PTA26076 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648425600000",
"number": "1689324865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23240 BRANDY RD",
"city": "LAND O LAKES",
"state": "FL",
"postal_code": "346392709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 CHESAPEAKE DR",
"city": "TARPON SPRINGS",
"state": "FL",
"postal_code": "346892515",
"telephone_number": "727-934-4629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENNA",
"first_name": "TODD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-28",
"last_updated": "2022-03-28",
"certification_date": "2022-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA26076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tarpon Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.