Individual provider Active NPI

Virsie Colquitt

  • Physical Therapy Assistant
  • Winter Park, FL
National Provider Identifier
1790052835
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
925 S Semoran Blvd
Suite 108
Winter Park, FL 32792-5313
Phone
(877) 430-2772
NPI assigned
Nov 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

925 S Semoran Blvd
Suite 108
Winter Park, FL 32792-5313

Mailing address

14612 Center Ave
Harvey, IL 60426-1729
Phone (708) 935-0729

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

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1790052835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14612 CENTER AVE",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604261729",
            "telephone_number": "708-935-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S SEMORAN BLVD",
            "address_2": "SUITE 108",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327925313",
            "telephone_number": "877-430-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLQUITT",
        "first_name": "VIRSIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.