Active NPI
Daniel Reynolds, P.T.
- Physical Therapist
- Melbourne, FL
National Provider Identifier
1699982025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21944
- Practice address
- 8725 N Wickham Rd
Suite 301
Melbourne, FL 32940-5997 - Phone
- (321) 434-9200
- Fax
- (321) 434-9202
- NPI assigned
- May 16, 2007
- Last updated
- Mar 12, 2020
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225100000X | 21944 | FL | Primary |
Addresses
Primary practice location
8725 N Wickham Rd
Suite 301
Melbourne, FL 32940-5997
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01425141 | Other | FL | FL RR |
| U5421X | Other | FL | MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21944 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Free Motion Physical Therapy of Brevard PA | Physical Therapist | Past | Accepting new patients |
| N.E. Physical Therapy Plus, P.C. | Physical Therapist | Past | Accepting new patients |
| Free Motion Physical Therapy of Brevard P.a. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Physical Therapist
- Melbourne, FL
- NPI 1982798963
-
- Physical Therapist
- Rockledge, FL
- NPI 1467624874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583971200000",
"number": "1699982025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8725 N WICKHAM RD",
"address_2": "SUITE 301",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329405997",
"telephone_number": "321-434-9200",
"fax_number": "321-434-9202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "DANIEL",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2020-03-12",
"certification_date": "2020-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "21944",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL RR",
"identifier": "P01425141",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "U5421X",
"state": "FL"
}
],
"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 Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.