Individual provider Active NPI

Veronika Innis

  • Physical Therapy Assistant
  • Gainesville, FL
National Provider Identifier
1811393036
Registry record updated Nov 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 25283 Issued in FL
Practice address
6700 NW 10TH PL
Gainesville, FL 32605-4213
Phone
(352) 331-3111
NPI assigned
Nov 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 25283 FL Primary

Addresses

Primary practice location

6700 NW 10TH PL
Gainesville, FL 32605-4213

Mailing address

101 E State St
Kennett Square, PA 19348-3109

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

LicenseStateTypeSpecialty
PTA 25283FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1416096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416096000000",
    "number": "1811393036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 NW 10TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054213",
            "telephone_number": "352-331-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNIS",
        "first_name": "VERONIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-16",
        "last_updated": "2014-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 25283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

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

Verify at the official NPI Registry.