Individual provider Active NPI

Janet Marie Womack, PT

  • Physical Therapist
  • Indian Harbour Beach, FL
National Provider Identifier
1750480166
Registry record updated Nov 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18113 Issued in FL
Practice address
2030 S Patrick Dr Ste 3
Indian Harbour Beach, FL 32937-4400
Phone
(321) 802-8411
Fax
(321) 802-5811
NPI assigned
Sep 22, 2006
Last updated
Nov 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT18113 FL Primary

Addresses

Primary practice location

2030 S Patrick Dr Ste 3
Indian Harbour Beach, FL 32937-4400

Mailing address

6169 Jog Road
Suite A11
Lake Worth, FL 33467
Phone (561) 432-0111

Other practice location 1

6300 N Wickham Rd Ste 116
Viera, FL 32940-2023
Phone (321) 802-5814

Other practice location 2

5445 Murrell Rd Ste 105
Viera, FL 32955-6679
Phone (321) 802-5814

Other practice location 3

709 S Harbor City Blvd Ste 100
Melbourne, FL 32901
Phone (321) 802-5814

Other identifiers 3

IdentifierTypeStateIssuer
Y9850OtherFLFLORIDA BLUE
Y9850YOtherFLFLORIDA MEDICARE FCSO
891438900MedicaidFL

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

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573257600000",
    "number": "1750480166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6169 JOG ROAD",
            "address_2": "SUITE A11",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33467",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 S PATRICK DR STE 3",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374400",
            "telephone_number": "321-802-8411",
            "fax_number": "321-802-5811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6300 N Wickham Rd Ste 116",
            "address_purpose": "LOCATION",
            "city": "Viera",
            "state": "FL",
            "postal_code": "329402023",
            "country_code": "US",
            "telephone_number": "321-802-5814",
            "fax_number": "321-802-5811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5445 Murrell Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Viera",
            "state": "FL",
            "postal_code": "329556679",
            "country_code": "US",
            "telephone_number": "321-802-5814",
            "fax_number": "321-802-5811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "709 S Harbor City Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "32901",
            "country_code": "US",
            "telephone_number": "321-802-5814",
            "fax_number": "321-502-5811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "JANET",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2019-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "Y9850",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICARE FCSO",
            "identifier": "Y9850Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891438900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Harbour Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2019; 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.