Thera Way Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT20821 Issued in FL

Legal business name

THERA WAY INC.

Practice address

443 SE Nome Dr
Port St Lucie, FL 34984-8902

Phone

(772) 240-5527

Fax

(772) 344-4851

NPI assigned

Dec 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mark Sapio Documento, RPT

Title

Administrative Director

Phone

(772) 240-5527

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1197158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1740463116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 SE NOME DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349848902",
            "telephone_number": "772-240-5527",
            "fax_number": "772-344-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 SE NOME DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349848902",
            "telephone_number": "772-240-5527",
            "fax_number": "772-344-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERA WAY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-09",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "DOCUMENTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "SAPIO",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "772-240-5527",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20821",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Port St Lucie, FL
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.