Individual provider Active NPI

Desmond Frazier

  • Physical Therapist
  • Davie, FL
National Provider Identifier
1780391185
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT39455 Issued in FL
Practice address
5850 S Pine Island Rd
Davie, FL 33328-5933
Phone
(305) 501-0231
NPI assigned
Nov 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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 PT39455 FL Primary

Addresses

Primary practice location

5850 S Pine Island Rd
Davie, FL 33328-5933

Mailing address

821 NW 85TH Ter Apt 2211
Plantation, FL 33324-1239
Phone (954) 734-0939

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
PT39455FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1780391185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 NW 85TH TER APT 2211",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241239",
            "telephone_number": "954-734-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 S PINE ISLAND RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285933",
            "telephone_number": "305-501-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "DESMOND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT39455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.