Individual provider Active NPI

Lydia Ware

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1871110122
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT35893 Issued in FL
Practice address
3411 S Dale Mabry Hwy Ste a
Tampa, FL 33629-8658
Phone
(813) 742-9501
NPI assigned
Jul 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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 PT35893 FL Primary

Addresses

Primary practice location

3411 S Dale Mabry Hwy Ste a
Tampa, FL 33629-8658

Mailing address

3411 S Dale Mabry Hwy Ste a
Tampa, FL 33629-8658
Phone (813) 742-9501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200817000691 FL Practitioner - Physical Therapist in Private Practice 3870919269 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT35893FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports and Orthopedic Rehabilitation Services, Inc. CurrentSince Jan 17, 2022 Accepting new patients
McKee Therapy Specialists, LLC CurrentSince Jul 29, 2020 Accepting new patients
Sports and Orthopedic Rehabilitation Services Inc CurrentSince Jan 17, 2022 Accepting new patients

Locations

18860 N Dale Mabry Hwy
Lutz, FL 33548
Phone (813) 347-2539

15310 Amberly Dr
Ste 155
Tampa, FL 33647
Phone (727) 777-2705

3411 S Dale Mabry Hwy
Ste A
Tampa, FL 33629
Phone (813) 742-9501

Networks

  • Optimum HealthCare 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": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1871110122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 S DALE MABRY HWY STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336298658",
            "telephone_number": "813-742-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 S DALE MABRY HWY STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336298658",
            "telephone_number": "813-742-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARE",
        "first_name": "LYDIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT35893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.