Mary Fox, PT, DPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30980 Issued in FL

Practice address

612 Druid Rd E
Ste D
Clearwater, FL 33756-3912

Phone

(727) 475-5543

NPI assigned

Dec 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ginny Fox Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Optimal Performance and Physical Therapies Palm Harbor LLC

  • Physical Therapist
  • Palm Harbor, FL
  • NPI 1437456167
  NPD (past)

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1750746798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 NORTHDALE BLVD",
            "address_2": "STE 111W",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241853",
            "telephone_number": "727-475-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 DRUID RD E",
            "address_2": "STE D",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563912",
            "telephone_number": "727-475-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "MARY",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "30980",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016402200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "RWEG2",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINNY",
            "last_name": "FOX",
            "credential": "PT, DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Colleen Geraldine Fowler
• Hannah Stewart Fowler, PA-C
• Benjamin Davis Fox, M.D.
• Donald M Fox, D.D.S.
• John G Fox, MD
• Matthew L Fox, LMHC
• Leosvel Fraga
• Angeline Fraley, LMHC
• Robert William Franceskino Jr., PA-C
• Francis Home Alf 2

• Physical Therapist in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; 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.