Individual provider Active NPI

Daniel Joseph Lapolla, PTA

  • Physical Therapy Assistant
  • Ormond Beach, FL
National Provider Identifier
1730569971
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA25717 Issued in FL
Practice address
1275 Granada Blvd
Suite 4B2
Ormond Beach, FL 32174
Phone
(386) 615-1112
Fax
(386) 615-1164
NPI assigned
Jun 3, 2015
Last updated
Aug 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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 PTA25717 FL Primary

Addresses

Primary practice location

1275 Granada Blvd
Suite 4B2
Ormond Beach, FL 32174

Mailing address

1275 Granada Blvd
Suite 4B2
Ormond Beach, FL 32174
Phone (386) 615-1112

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
PTA25717FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1730569971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 GRANADA BLVD",
            "address_2": "SUITE 4B2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-615-1112",
            "fax_number": "386-615-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 GRANADA BLVD",
            "address_2": "SUITE 4B2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-615-1112",
            "fax_number": "386-615-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAPOLLA",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-03",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA25717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.