Haley Rebecca Paulk, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40561 Issued in FL

Practice address

5300 S Ferdon Blvd
Crestview, FL 32536-5235

Phone

(850) 863-2153

NPI assigned

Aug 7, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Axis Physiotherapy Institute, LLCGroup PAC ID 2860825353, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Axis Physiotherapy Institute, LLC

  • Physical Therapist
  • Fort Walton Beach, FL
  • NPI 1790328045
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1801626452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 SHARON CT",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324333523",
            "telephone_number": "850-333-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 S FERDON BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365235",
            "telephone_number": "850-863-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULK",
        "first_name": "HALEY",
        "middle_name": "REBECCA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neil Patel, DPM
• Rutvi Patel, MD
• Zakia Patrick
• Becky Christine Patterson, LCSW
• Christina Patterson
• Pax Cardiovascular Specialists LLC
• Peachy Orchard LLC
• Tonie Lyn Peasley, OTR/L
• Pensacola Nephrology, PA (Renalus Center for Kidney Care)
• Gary Charles Perez, PHYSICIAN ASSISTANT

• Physical Therapist in Crestview, FL
• Providers in Crestview, 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 7, 2024; 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.