Active NPI
Advanced Physical Therapy & Rehab of Lee, LLC
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Fort Myers, FL
National Provider Identifier
1710930623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Legal business name
- ADVANCED PHYSICAL THERAPY & REHAB OF LEE, LLC
- Practice address
- 6314 Whiskey Creek Dr Ste D
Fort Myers, FL 33919-8762 - Phone
- (239) 432-0556
- Fax
- (239) 432-9727
- NPI assigned
- May 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amanda Streeter
- Title
- Vice President
- Phone
- (800) 699-9395
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | Primary |
Addresses
Primary practice location
6314 Whiskey Creek Dr Ste D
Fort Myers, FL 33919-8762
Mailing address
PO Box 932184
Atlanta, GA 31193-2184
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008812000 | Medicaid | FL | |
| 6527110001 | Other | FL | DMEPOS |
| 362346700 | Other | FL | FL DEPT OF LABOR |
| GG4 | Other | FL | BLUE CROSS BLUE SHIELD FL |
Other names 1
- Advanced Physical Therapy & Rehab
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030805000017 | FL | Part A Provider - Comprehensive Outpatient Rehabilitation Facility | 5193636827 | Practice locations: Fort Myers, FL |
Comprehensive outpatient rehabilitation facility certification: CCN 684861
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- ADVANCED PHYSICAL THERAPY & REHAB OF LEE INC
- Certification status
- Active
- Provider type (POS)
- Comprehensive outpatient rehabilitation facility
- Participating since
- Jul 1, 2003
- Last certification
- Feb 15, 2023
- Ownership / control type
- Proprietary
- Facility address
- 6314 Whiskey Creek Dr
Fort Myers, FL 33919
National Provider Directory
National Provider DirectoryLocations
6314 Whiskey Creek Dr
Ste D
Fort Myers, FL 33919
Phone (239) 432-0556
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Fort Myers, FL
- NPI 1881927630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708905600000",
"number": "1710930623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 932184",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311932184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6314 WHISKEY CREEK DR STE D",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339198762",
"telephone_number": "239-432-0556",
"fax_number": "239-432-9727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED PHYSICAL THERAPY & REHAB OF LEE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-19",
"last_updated": "2024-02-26",
"certification_date": "2024-02-26",
"status": "A",
"authorized_official_last_name": "STREETER",
"authorized_official_first_name": "AMANDA",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "800-699-9395"
},
"taxonomies": [
{
"code": "261QR0401X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008812000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMEPOS",
"identifier": "6527110001",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL DEPT OF LABOR",
"identifier": "362346700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD FL",
"identifier": "GG4",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Advanced Physical Therapy & Rehab",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Advanced Physical Therapy & Rehab",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Myers, FL
- Advanced Home Oxygen & Medical Equipment Inc
- Advanced Labs of SW Florida, LLC
- Advanced Lift Systems
- Advanced Pain Management Specialist
- Advanced Pain Management Specialists
- Advanced Podiatry and Neuropathy Center LLC
- Advanced Psychiatric Care, PC
- Advanced Radiology Imaging Associates LLC
- Advanced Spine and Wellness Center, Inc
- Advanced Surgery Center of Fort Myers LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.