Individual provider Active NPI

Jennifer Bargo, PT

  • Physical Therapist
  • Merritt Island, FL
National Provider Identifier
1811200090
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18400 Issued in FL
Practice address
595 N Courtenay Pkwy
Suite 203
Merritt Island, FL 32953-4851
Phone
(321) 453-8484
Fax
(321) 453-8448
NPI assigned
Jul 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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 PT18400 FL Primary

Addresses

Primary practice location

595 N Courtenay Pkwy
Suite 203
Merritt Island, FL 32953-4851

Mailing address

PO Box 541210
Merritt Island, FL 32954-1210
Phone (321) 453-8484

Other names 1

  • Jennifer Oswald Former name

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1811200090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541210",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329541210",
            "telephone_number": "321-453-8484",
            "fax_number": "321-453-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 N COURTENAY PKWY",
            "address_2": "SUITE 203",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534851",
            "telephone_number": "321-453-8484",
            "fax_number": "321-453-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARGO",
        "first_name": "JENNIFER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "OSWALD",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.