Active NPI
Divina Rich, P.T.
- Geriatric Physical Therapist
- Stuart, FL
National Provider Identifier
1811284581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 4480
- Practice address
- 1500 Palm Beach Rd
Stuart, FL 34994-4044 - Phone
- (772) 283-5887
- NPI assigned
- Jul 1, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 26476 | FL | |
| Geriatric Physical Therapist | 2251G0304X | 4480 | CO | Primary |
Addresses
Primary practice location
1500 Palm Beach Rd
Stuart, FL 34994-4044
Mailing address
1706 Andrews Way
Orange Park, FL 32073-2784
Phone (808) 346-2473
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4480 | CO | MD | Geriatric Physical Therapist |
| 26476 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1811284581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1706 ANDREWS WAY",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320732784",
"telephone_number": "808-346-2473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 PALM BEACH RD",
"city": "STUART",
"state": "FL",
"postal_code": "349944044",
"telephone_number": "772-283-5887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICH",
"first_name": "DIVINA",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-01",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "FL",
"license": "26476",
"primary": false
},
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "CO",
"license": "4480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.