Organization Active NPI

Orthosport Inc.

  • Physical Therapist
  • Davie, FL
National Provider Identifier
1689693848
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 17930 Issued in FL
Legal business name
ORTHOSPORT INC.
Practice address
5200 S University Dr
Suite 105-a
Davie, FL 33328-5316
Phone
(954) 382-4343
Fax
(954) 382-4342
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Howard Layne, D.P.T.NPI 1851510218
Title
Owner
Phone
(954) 382-4343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT 17930 FL Primary

Addresses

Primary practice location

5200 S University Dr
Suite 105-a
Davie, FL 33328-5316

Mailing address

5200 S University Dr
Suite 105-a
Davie, FL 33328-5316
Phone (954) 382-4343

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061206000165 FL Part B Supplier - Clinic/Group Practice 6305844614 Receives reassigned benefits from 2 practitioners
Practice locations: Davie, FL

National Provider Directory

National Provider Directory

Locations

5200 S University Dr
Ste 105A
Davie, FL 33328
Phone (954) 382-4343

5200 S University Dr
Ste 105
Davie, FL 33328
Phone (954) 382-4343

5800 Colonial Dr
Ste 400
Margate, FL 33063
Phone (954) 881-0890

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689693848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 S UNIVERSITY DR",
            "address_2": "SUITE 105-A",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285316",
            "telephone_number": "954-382-4343",
            "fax_number": "954-382-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 S UNIVERSITY DR",
            "address_2": "SUITE 105-A",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285316",
            "telephone_number": "954-382-4343",
            "fax_number": "954-382-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOSPORT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAYNE",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-382-4343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 17930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.