NPIMap

Organization Active NPI

Nokomis Physical Therapy LLC

  • Rehabilitation Clinic/Center
  • Nokomis, FL
National Provider Identifier
1780964973
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
NOKOMIS PHYSICAL THERAPY LLC
Practice address
109 Laurel Rd E
Nokomis, FL 34275-5233
Phone
(941) 706-1230
NPI assigned
Aug 19, 2011
Last updated
Oct 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Authorized official

Name
Kenneth I Tribit, P.T.NPI 1407921968
Title
President
Phone
(941) 706-1230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

109 Laurel Rd E
Nokomis, FL 34275-5233

Mailing address

4964 Fruitville Rd
Sarasota, FL 34232-2261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111012000808 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8628240843 Receives reassigned benefits from 2 practitioners
Practice locations: Nokomis, FL
O20120501000491 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 8628240843 Practice locations: Bradenton, FL; Englewood, FL; Nokomis, FL; Sarasota, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780964973. Details of each certification follow.

  • CCN 686898 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 686898

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
NOKOMIS PHYSICAL THERAPY LLC
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Feb 12, 2013
Last certification
Feb 13, 2013
Ownership / control type
Proprietary
Facility address
109 Laurel Rd E
Nokomis, FL 34275

National Provider Directory

National Provider Directory

Locations

308 53rd Ave E
#B
Bradenton, FL 34203
Phone (941) 375-8734

4964 Fruitville Rd
Sarasota, FL 34232
Phone (941) 341-9480

Practitioners & affiliated clinicians

Practitioners 105

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 105

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317859200000",
    "number": "1780964973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4964 FRUITVILLE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342322261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LAUREL RD E",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342755233",
            "telephone_number": "941-706-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOKOMIS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-10-06",
        "status": "A",
        "authorized_official_last_name": "TRIBIT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-706-1230",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nokomis, FL

Sources for this page

Verify at the official NPI Registry.