Individual provider Active NPI

Caitlin Flannery, PT, DPT

  • Physical Therapist
  • St Petersburg, FL
National Provider Identifier
1780411629
Registry record updated Oct 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT45452 Issued in FL
Practice address
9355 4TH St N
St Petersburg, FL 33702-3133
Phone
(727) 579-7974
NPI assigned
Sep 16, 2024
Last updated
Oct 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT45452 FL Primary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X CP043599T NC
Physical Therapist 225100000X 40QA02292100 NJ

Addresses

Primary practice location

9355 4TH St N
St Petersburg, FL 33702-3133

Mailing address

1318 Laurel Ave
Sea Girt, NJ 08750-2305
Phone (732) 272-2523

Other practice location 1

19 Mule Rd
Toms River, NJ 08755-5061
Phone (732) 505-1300

Other practice location 2

319 W Wendover Ave
Greensboro, NC 27408-8401
Phone (336) 274-5006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241021002169 NJ Practitioner - Physical Therapist in Private Practice 0941732507 Reassigns benefits to 1 organization
I20251119000518 NC Practitioner - Physical Therapist in Private Practice 0941732507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

319 W Wendover Ave
Greensboro, NC 27408-8401
Phone (336) 274-5006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT45452FLMDPhysical Therapist
CP043599TNCMDPhysical Therapist
40QA02292100NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist CurrentSince Sep 16, 2024 Accepting new patients
Greensboro Physical Therapy & Sports Medicine Services, LLC Single Specialty CurrentSince Sep 22, 2025 Accepting new patients
Greensboro Physical Therapy and Sports Medicine Services Single Specialty CurrentSince Sep 22, 2025 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Sep 16, 2024 Accepting new patients

Locations

319 W Wendover Ave
Greensboro, NC 27408
Phone (336) 274-5006

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

19 Mule Rd
Toms River, NJ 08755
Phone (732) 240-1400

600 Mule Rd
Ste 1
Toms River, NJ 08757
Phone (732) 505-1300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791676800000",
    "number": "1780411629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 LAUREL AVE",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087502305",
            "telephone_number": "732-272-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9355 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337023133",
            "telephone_number": "727-579-7974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Mule Rd",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087555061",
            "country_code": "US",
            "telephone_number": "732-505-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 W Wendover Ave",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274088401",
            "country_code": "US",
            "telephone_number": "336-274-5006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "CAITLIN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-10-11",
        "certification_date": "2026-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT45452",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "CP043599T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02292100",
            "primary": false
        }
    ],
    "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 Oct 11, 2026; 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.