Active NPI
Jay Wendell Regencia Sia
- Physical Therapist
- Ormond Beach, FL
National Provider Identifier
1811319767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT25069
- Practice address
- 875 Wilmette Ave Apt 406
Ormond Beach, FL 32174-9515 - Phone
- (863) 414-8822
- NPI assigned
- Jan 13, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT25069 | FL | Primary |
Addresses
Primary practice location
875 Wilmette Ave Apt 406
Ormond Beach, FL 32174-9515
Mailing address
875 Wimette Ave. Apt 406
Ormond Beach, FL 32174
Phone (863) 414-8822
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 |
|---|---|---|---|
| PT25069 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389571200000",
"number": "1811319767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "875 WIMETTE AVE. APT 406",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "32174",
"telephone_number": "863-414-8822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 WILMETTE AVE APT 406",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321749515",
"telephone_number": "863-414-8822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIA",
"first_name": "JAY WENDELL",
"middle_name": "REGENCIA",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-13",
"last_updated": "2014-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT25069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
- Sherry Shawky Shnouda, PHARM D
- Elizabeth Ann Shoemaker, LMFT
- James Richard Shoemaker, DO
- Whitney E Shoemaker, D.O., F.A.C.O.O.G.
- Shorecoast ER SVCS Partnership LLC
- Jennifer Anne Sibley, DNP, ARNP, CPNP-PC
- Robert Barry Siegel, AU.D.
- Lawrence Sigafoos II, P.T.A.
- Silver Manor by the Sea, LLC
- Megan Silvernail
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.