Individual provider Active NPI

Joni M. Robertson, PT

  • Physical Therapist
  • Ormond Beach, FL
National Provider Identifier
1831524966
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33143 Issued in FL
Practice address
3612 Christa CT
Ormond Beach, FL 32174-2874
Phone
(901) 581-4539
Fax
(833) 527-7700
NPI assigned
Sep 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5365 TN
Orthopedic Physical Therapist 2251X0800X 5365 TN
Physical Therapist 225100000X 33143 FL Primary

Addresses

Primary practice location

3612 Christa CT
Ormond Beach, FL 32174-2874

Mailing address

PO Box 730052
Ormond Beach, FL 32173-0052
Phone (901) 581-4539

Other practice location 1

2735 Highway 64
Suite 107
Eads, TN 38028-3333
Phone (901) 235-6171

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

State licenses

LicenseStateTypeSpecialty
2735TNMDOptometrist
33143FLMDPhysical Therapist
5365TNMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Mobile Physical Therapy, Fitness and Golf Rehab CurrentSince Apr 18, 2019 Accepting new patients

Organizations & group practices 1

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1831524966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730052",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321730052",
            "telephone_number": "901-581-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 CHRISTA CT",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321742874",
            "telephone_number": "901-581-4539",
            "fax_number": "833-527-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2735 Highway 64",
            "address_2": "SUITE 107",
            "address_purpose": "LOCATION",
            "city": "Eads",
            "state": "TN",
            "postal_code": "380283333",
            "country_code": "US",
            "telephone_number": "901-235-6171",
            "fax_number": "901-235-6463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JONI",
        "middle_name": "M.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "5365",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TN",
            "license": "5365",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "33143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.