Individual provider Active NPI

Robert James Corris II, PT

  • Physical Therapist
  • Palm Harbor, FL
National Provider Identifier
1780703074
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8071 Issued in FL
Practice address
4705 Alt 19
Suite a
Palm Harbor, FL 34683-1440
Phone
(727) 781-3550
Fax
(727) 781-3450
NPI assigned
Mar 28, 2007
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 PT8071 FL Primary

Addresses

Primary practice location

4705 Alt 19
Suite a
Palm Harbor, FL 34683-1440

Mailing address

4705 Alt 19
Suite a
Palm Harbor, FL 34683-1440
Phone (727) 781-3550

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
PT8071FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780703074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 ALT 19",
            "address_2": "SUITE A",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831440",
            "telephone_number": "727-781-3550",
            "fax_number": "727-781-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 ALT 19",
            "address_2": "SUITE A",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831440",
            "telephone_number": "727-781-3550",
            "fax_number": "727-781-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRIS",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT8071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, 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.