Orthopedic & Sports Physical Therapy Center LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ORTHOPEDIC & SPORTS PHYSICAL THERAPY CENTER LLC

Practice address

610 Hospital Dr
Crestview, FL 32539-7356

Phone

(850) 683-0077

Fax

(850) 683-0099

NPI assigned

Jun 2, 2006

Last updated

Apr 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Nicole Sheppard

Title

Practice Administrator

Phone

(850) 897-3334

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Orthopedic & Sports Physical Therapy Center LLC

  • Physical Therapy Clinic/Center
  • Niceville, FL
  • NPI 1881632008

  O20050418000712

  Same enrollment

Locations

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ross Steven Burks, PT, DPT

  • Physical Therapist
  • Niceville, FL
  • NPI 1750621223
  NPD
• Landyn Lynn Clark Yudez

  • Physical Therapist
  • Niceville, FL
  • NPI 1780149757
  NPD
• David Davis, PT, OCS

  • Physical Therapist
  • Niceville, FL
  • NPI 1326058264
  NPD
• Melissa Renee Duhaime, PT

  • Physical Therapist
  • Niceville, FL
  • NPI 1134225105
  NPD
• Matthew R Fischer, DPT

  • Physical Therapist
  • Chipley, FL
  • NPI 1619577921
  NPD
• Deborah Delan Gilliam, PT

  • Physical Therapist
  • Panama City, FL
  • NPI 1508244674
  NPD
• Kody Dewayne McGhee, OT

  • Occupational Therapist
  • Niceville, FL
  • NPI 1083368815
  NPD
• Lincoln Norris

  • Physical Therapist
  • Niceville, FL
  • NPI 1831895515
  NPD
• Regina A Patton, PT

  • Physical Therapist
  • Niceville, FL
  • NPI 1558501072
  NPD
• Robert James Seton, MPT, OCS

  • Physical Therapist
  • Destin, FL
  • NPI 1740217967
  NPD
• Caylin Jeanne Bauld, PT

  • Physical Therapist
  • Fort Bragg, NC
  • NPI 1790480986
  NPD

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1700823044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 HOSPITAL DRIVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "32539",
            "telephone_number": "850-683-0077",
            "fax_number": "850-683-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 HOSPITAL DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325397356",
            "telephone_number": "850-683-0077",
            "fax_number": "850-683-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPORTS PHYSICAL THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "850-897-3334",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913153-02",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL GROUP#",
            "identifier": "Y906Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rikki Ann Flores Ordinario
• Lonelle Ordway, LCSW
• Mykayla Orner
• Cristian J Ortega
• Orthopaedic Associates, PA
• Robert Solomon Osborne, PT, DPT
• Overcoming Obstacles ABA LLC
• Brayden Oxborrow, DMD
• Christina Paczkowski, LMHC
• Carissa Marie Padilla

• Physical Therapy Clinic/Center in Crestview, FL
• Providers in Crestview, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.