Individual provider Active NPI

Wayne Bruce Whittle, P.T.

  • Physical Therapist
  • St. Petersburg, FL
National Provider Identifier
1770657264
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11711 Issued in FL
Practice address
40 66TH Street North
St. Petersburg, FL 33710-8408
Phone
(727) 345-3346
Fax
(727) 345-3595
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

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 11711 FL Primary

Addresses

Primary practice location

40 66TH Street North
St. Petersburg, FL 33710-8408

Mailing address

40 66TH Street North
St. Petersburg, FL 33710-8408
Phone (727) 345-3346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308000566 FL Practitioner - Physical Therapist in Private Practice 0244128601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Sports and Orthopedic TherapyGroup PAC ID 0446243729, 6 clinicians

Practice addresses (Care Compare)

40 66TH St N
St Petersburg, FL 33710-8408
Phone (727) 345-3346

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as group
Quality
94.53
Improvement activities
40
Cost
77.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11711FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Sports and Orthopedic Therapy Physical Therapist CurrentSince Jan 1, 2004 Accepting new patients
Suncoast Sports and Orthopedic Therapy CurrentSince Jan 1, 2004 Accepting new patients

Locations

110 Pinellas Way N
St Petersburg, FL 33710
Phone (727) 322-8883

40 66th St N
St Petersburg, FL 33710
Phone (727) 345-3346

5535 Park St N
St Petersburg, FL 33709
Phone (727) 209-0579

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1770657264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 66TH STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337108408",
            "telephone_number": "727-345-3346",
            "fax_number": "727-345-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 66TH STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337108408",
            "telephone_number": "727-345-3346",
            "fax_number": "727-345-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTLE",
        "first_name": "WAYNE",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "11711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.