Individual provider Active NPI

David Lawrence Omura, MHA, MSPT

  • Physical Therapist
  • Gainesville, FL
National Provider Identifier
1760580732
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT16946 Issued in FL
Practice address
1601 SW Archer Rd
Gainesville, FL 32608-1135
Phone
(352) 376-1611
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT16946 FL Primary

Addresses

Primary practice location

1601 SW Archer Rd
Gainesville, FL 32608-1135

Mailing address

9901 SW 89TH St
Gainesville, FL 32608-8419
Phone (352) 495-3210

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
PT16946FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760580732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 SW 89TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088419",
            "telephone_number": "352-495-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081135",
            "telephone_number": "352-376-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMURA",
        "first_name": "DAVID",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "MHA, MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT16946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.