Individual provider Active NPI

Courtney Knoblauch, DPT

  • Physical Therapist
  • Wellington, FL
National Provider Identifier
1831963586
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT41016 Issued in FL
Practice address
1325 Longlea Ter
Wellington, FL 33414-9061
Phone
(561) 779-7998
NPI assigned
Nov 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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 PT41016 FL Primary

Addresses

Primary practice location

1325 Longlea Ter
Wellington, FL 33414-9061

Mailing address

1325 Longlea Ter
Wellington, FL 33414-9061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108005795 FL Practitioner - Physical Therapist in Private Practice 3476904079 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axispro Physical Therapy LLCGroup PAC ID 5395035158, 9 clinicians

Practice addresses (Care Compare)

5240 Babcock St NE
Suite 102
Palm Bay, FL 32905-4615
Phone (321) 327-8509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT41016FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Courtney Knoblauch, PT, DPT, LLC. Physical Therapist Current Accepting new patients
Coastal Orthopedics & Sports Medicine of Southwest Florida PA CurrentSince Dec 18, 2023 Accepting new patients

Locations

8000 State Road 64 E
Bradenton, FL 34212
Phone 94179214043315

8340 Lakewood Ranch Blvd
Ste 300
Lakewood Ranch, FL 34202
Phone (941) 316-8200

Networks

  • Freedom Health HMO Network

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": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1831963586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 LONGLEA TER",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334149061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 LONGLEA TER",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334149061",
            "telephone_number": "561-779-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOBLAUCH",
        "first_name": "COURTNEY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT41016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.