Active NPI
Audrey Stewart, PT, DPT
- Pediatric Physical Therapist
- Melbourne, FL
National Provider Identifier
1699095935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT25525
- Practice address
- 4450 W Eau Gallie Blvd
Suite 180
Melbourne, FL 32934-7213 - Phone
- (321) 255-6627
- NPI assigned
- Jun 9, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT25525 | FL | Primary |
Addresses
Primary practice location
4450 W Eau Gallie Blvd
Suite 180
Melbourne, FL 32934-7213
Mailing address
4775-2 Lake Waterford Way
Melbourne, FL 32901
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 |
|---|---|---|---|
| PT25525 | FL | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ability Plus Therapy Inc. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280793600000",
"number": "1699095935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4775-2 LAKE WATERFORD WAY",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "32901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4450 W EAU GALLIE BLVD",
"address_2": "SUITE 180",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329347213",
"telephone_number": "321-255-6627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "AUDREY",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-09",
"last_updated": "2010-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "FL",
"license": "PT25525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.