Individual provider Active NPI

Christine Vezzola, P.T.

  • Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1871519538
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT22288 Issued in FL
Practice address
8710 College Pkwy
Fort Myers, FL 33919-4811
Phone
(239) 482-8788
Fax
(239) 482-1566
NPI assigned
Jul 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 PT22288 FL Primary

Addresses

Primary practice location

8710 College Pkwy
Fort Myers, FL 33919-4811

Mailing address

8710 College Pkwy
Fort Myers, FL 33919-4811
Phone (239) 482-8788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060830000386 FL Practitioner - Physical Therapist in Private Practice 9537173539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abbott Kagan II MD PAGroup PAC ID 9537052949, 6 clinicians

Practice addresses (Care Compare)

8710 College Pkwy
Fort Myers, FL 33919-4811
Phone (239) 482-8788

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT22288FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Abbott Kagan II, M.D., P.a. CurrentSince May 1, 2012 Accepting new patients
MCRC Physical Therapy, LLC Physical Therapist PastSince May 19, 2008 Accepting new patients

Locations

5 Nicholas Pkwy W
Cape Coral, FL 33991
Phone (239) 458-3800

8710 College Pkwy
Fort Myers, FL 33919
Phone (239) 482-8788

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871519538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8710 COLLEGE PKWY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194811",
            "telephone_number": "239-482-8788",
            "fax_number": "239-482-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 COLLEGE PKWY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194811",
            "telephone_number": "239-482-8788",
            "fax_number": "239-482-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEZZOLA",
        "first_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, 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.
  • 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.