Active NPI
Frank Bernardus Van Kouwen, PT
- Physical Therapist
- Eustis, FL
National Provider Identifier
1720347156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 27064
- Practice address
- 443 Plaza Dr
Eustis, FL 32726-6523 - Phone
- (352) 589-5595
- Fax
- (352) 589-5747
- NPI assigned
- May 4, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 27064 | FL | Primary |
Addresses
Primary practice location
443 Plaza Dr
Eustis, FL 32726-6523
Mailing address
443 Plaza Dr
Eustis, FL 32726-6523
Phone (352) 589-5595
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720096720 | Other | NPI | |
| 686515 | Other | MEDICARE PTAN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 27064 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physio Sports Med, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336089600000",
"number": "1720347156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "443 PLAZA DR",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327266523",
"telephone_number": "352-589-5595",
"fax_number": "352-589-5747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "443 PLAZA DR",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327266523",
"telephone_number": "352-589-5595",
"fax_number": "352-589-5747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN KOUWEN",
"first_name": "FRANK",
"middle_name": "BERNARDUS",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-04",
"last_updated": "2012-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "27064",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1720096720",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "686515",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Eustis, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.