Individual provider Active NPI

Dena Susan Caltrider, MSPT

  • Physical Therapist
  • Port Orange, FL
National Provider Identifier
1861530586
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 21827 Issued in FL
Practice address
1525 Herbert St Unit 102-103
Port Orange, FL 32129-6106
Phone
(386) 756-0424
Fax
(386) 756-0425
NPI assigned
Feb 2, 2007
Last updated
Nov 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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 PT 21827 FL Primary

Addresses

Primary practice location

1525 Herbert St Unit 102-103
Port Orange, FL 32129-6106

Mailing address

1524 SW Gopher TRL
Palm City, FL 34990-2759
Phone (407) 443-3226

Other identifiers 1

IdentifierTypeStateIssuer
PT21827OtherFLPHYSICAL THERAPY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200106000169 FL Practitioner - Physical Therapist in Private Practice 7517391246 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 21827FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Rehab Group LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Strength and Balance Institute Physical Therapist CurrentSince Nov 22, 2019 Accepting new patients

Locations

7950 Dani Dr
#1402
Fort Myers, FL 33966
Phone (561) 900-2423

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1861530586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 SW GOPHER TRL",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902759",
            "telephone_number": "407-443-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 HERBERT ST UNIT 102-103",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296106",
            "telephone_number": "386-756-0424",
            "fax_number": "386-756-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALTRIDER",
        "first_name": "DENA",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 21827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT21827",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.