Wellington Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT27611 Issued in FL

Legal business name

WELLINGTON PHYSICAL THERAPY INC

Practice address

12797 W. Forest Hill Blvd
Suite B
Wellington, FL 33414

Phone

(561) 793-5550

NPI assigned

Jan 1, 2007

Last updated

Aug 19, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Tavolacci, D.C.NPI 1558686014

Title

Manager

Phone

(561) 793-5550

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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.

• Matthew John Tavolacci, D.C.

  • Chiropractor
  • Wellington, FL
  • NPI 1558686014
  Medicare reassignment NPD Authorized official
• Krysten Saccocio, PT, DPT

  • Physical Therapist
  • Wellington, FL
  • NPI 1144775073
  Medicare reassignment
• Ronald Tietjen, DC

  • Chiropractor
  • Wellington, FL
  • NPI 1750448866
  NPD (past)

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1790842854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12797 W. FOREST HILL BLVD",
            "address_2": "SUITE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "33414",
            "telephone_number": "561-793-5550",
            "fax_number": "561-793-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12797 W. FOREST HILL BLVD",
            "address_2": "SUITE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "33414",
            "telephone_number": "561-793-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLINGTON PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-01",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "TAVOLACCI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-793-5550",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10273",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21779",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellington Inpatient Specialists PLLC
• Wellington Internal Medicine Group PA
• Wellington Medical Supplies Inc
• Wellington Medstat LLC (ER Doctors Urgent Care)
• Wellington Orthopedic Institute, LLC
• Wellington Physician Alliances Inc
• Wellington Regional Medical Center LLC (Center for Wound Care and Hyperbaric Medicine)
• Wellington Regional Medical Center LLC (Wellington Surgery Center)
• Wellington Regional Medical Center LLC (Wellington Regional Medical Center)
• Wellington Regional Medical Center LLC (Wellington Regional Outpatient Diagnostic Center)

• Physical Therapist in Wellington, FL
• Providers in Wellington, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.