Individual provider Active NPI

Maimi Kobayashi

  • Physical Therapist
  • South Daytona, FL
National Provider Identifier
1710291448
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01182300 Issued in NJ
Practice address
917 Beville Rd
Ste G
South Daytona, FL 32119-1712
Phone
(800) 330-7711
NPI assigned
Aug 5, 2010
Last updated
Aug 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01182300 NJ Primary

Addresses

Primary practice location

917 Beville Rd
Ste G
South Daytona, FL 32119-1712

Mailing address

383 Douglas Rd
Roselle, NJ 07203-3012

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

LicenseStateTypeSpecialty
40QA01182300NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1710291448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 DOUGLAS RD",
            "city": "ROSELLE",
            "state": "NJ",
            "postal_code": "072033012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 BEVILLE RD",
            "address_2": "STE G",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191712",
            "telephone_number": "800-330-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBAYASHI",
        "first_name": "MAIMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01182300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.

Verify at the official NPI Registry.