Active NPI
Jeanette Van Duyne, PT
- Specialist
- Titusville, FL
National Provider Identifier
1710105267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PT18971
- Practice address
- 5650 S Washington Ave
Titusville, FL 32780-7312 - Phone
- (321) 264-9331
- NPI assigned
- Apr 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | PT18971 | FL | Primary |
Addresses
Primary practice location
5650 S Washington Ave
Titusville, FL 32780-7312
Mailing address
2539 Norma St
Titusville, FL 32780-2845
Phone (321) 267-4984
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 |
|---|---|---|---|
| PT18971 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710105267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2539 NORMA ST",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327802845",
"telephone_number": "321-267-4984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5650 S WASHINGTON AVE",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327807312",
"telephone_number": "321-264-9331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DUYNE",
"first_name": "JEANETTE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "PT18971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Titusville, FL
- Alyssa Chinyere Umeh
- Urgent Care Centers of Brevard County LLC (Health First AdventHealth Centra Care Titusville)
- Kathleen Rae Uvaro, L.M.T.
- Candice Maria Vaknin, MSN, APRN, FNP-C
- Heyoan Valdes Gonzalez, RBT
- Cheryl Marie Van Dyke, LPC
- Melissa Sue Van Keuren, MA
- Aimee Jynette Vance, PA-C
- Leonard Vaneaton, M.D.
- Kimberly Kay Vanpelt, MS ED CCC/SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.