Organization Active NPI

Functional Solutions, LLC

  • Physical Therapist
  • Middleburg, FL
National Provider Identifier
1700535309
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FUNCTIONAL SOLUTIONS, LLC
Practice address
2620 Blanding Blvd Ste 11
Middleburg, FL 32068-9109
Phone
(904) 564-0029
NPI assigned
Mar 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Lynn A Swartz, DPT, ECHMNPI 1588949184
Title
Owner
Phone
(904) 564-0029

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: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2620 Blanding Blvd Ste 11
Middleburg, FL 32068-9109

Mailing address

2620 Blanding Blvd Ste 11
Middleburg, FL 32068-9109
Phone (904) 406-0037

Other identifiers 1

IdentifierTypeStateIssuer
887663106MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221201002143 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3274901814 Receives reassigned benefits from 1 practitioner
Practice locations: Middleburg, FL

National Provider Directory

National Provider Directory

Locations

2620 Blanding Blvd
Ste 11
Middleburg, FL 32068
Phone (904) 406-0037

Practitioners & affiliated clinicians

Practitioners 1

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": "1647820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1700535309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 BLANDING BLVD STE 11",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320689109",
            "telephone_number": "904-406-0037",
            "fax_number": "904-406-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 BLANDING BLVD STE 11",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320689109",
            "telephone_number": "904-564-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-21",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "SWARTZ",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-564-0029",
        "authorized_official_credential": "DPT, ECHM"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887663106",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.