Individual provider Active NPI

Allen M Weiss, MPT,ATC/L

  • Physical Therapist
  • Orange Park, FL
National Provider Identifier
1821096280
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT15505 Issued in FL
Practice address
1835-16 East West Parkway
Orange Park, FL 32003-7450
Phone
(904) 215-3958
Fax
(904) 215-3970
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT15505 FL Primary

Addresses

Primary practice location

1835-16 East West Parkway
Orange Park, FL 32003-7450

Mailing address

2140 Kingsley Ave
Suite 5
Orange Park, FL 32073-5180
Phone (904) 215-3958

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
PT15505FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy and Rehabiliation Clinic Inc Physical Therapist Past Accepting new patients
Physical Therapy & Rehabilitation Clinic Inc Past Accepting new patients
Physical Therapy Associates of Orange Park, Inc Physical Therapist PastSince Feb 1, 2000 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821096280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE",
            "address_2": "SUITE 5",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735180",
            "telephone_number": "904-215-3958",
            "fax_number": "904-215-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835-16 EAST WEST PARKWAY",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320037450",
            "telephone_number": "904-215-3958",
            "fax_number": "904-215-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "ALLEN",
        "middle_name": "M",
        "credential": "MPT,ATC/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT15505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.