Individual provider Active NPI

Eniko Korodi

  • Physical Therapy Assistant
  • Port Charlotte, FL
National Provider Identifier
1710469184
Registry record updated Sep 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
28234 Issued in FL
Practice address
4000 Kings Hwy
Port Charlotte, FL 33980
Phone
(941) 356-1741
NPI assigned
Sep 3, 2018
Last updated
Sep 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 28234 FL Primary

Addresses

Primary practice location

4000 Kings Hwy
Port Charlotte, FL 33980

Mailing address

12077 Warden Ave
Port Charlotte, FL 33981
Phone (941) 356-1741

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

LicenseStateTypeSpecialty
28234FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535932800000",
    "number": "1710469184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12077 WARDEN AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33981",
            "telephone_number": "941-356-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KINGS HWY",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33980",
            "telephone_number": "941-356-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORODI",
        "first_name": "ENIKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-03",
        "last_updated": "2018-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "28234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2018; 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.