NPIMap

Organization Active NPI

Southwest Orthopedic & Sports Physical Therapy

Doing business as S O S Physical Therapy

  • Physical Therapist
  • Punta Gorda, FL
National Provider Identifier
1871542217
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3524 Issued in FL
Legal business name
SOUTHWEST ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Doing business as
S O S Physical Therapy
Practice address
315 E Olympia Ave
Suite 212
Punta Gorda, FL 33950-3833
Phone
(941) 255-5940
Fax
(941) 255-5943
NPI assigned
May 10, 2006
Last updated
Oct 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Authorized official

Name
Teresa Martin, PTNPI 1174827349
Title
Vice President
Phone
(941) 255-5940

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT3524 FL Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT2914 FL

Addresses

Primary practice location

315 E Olympia Ave
Suite 212
Punta Gorda, FL 33950-3833

Mailing address

315 E Olympia Ave
Suite 212
Punta Gorda, FL 33950-3833
Phone (941) 255-5940

Other identifiers 2

IdentifierTypeStateIssuer
QK8OtherFLBLUE CROSS BLUE SHIELD
R6VOtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • S O S Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

2327 Aaron St
Pt Charlotte, FL 33952
Phone (800) 771-7164

315 E Olympia Ave
Unit 212
Punta Gorda, FL 33950
Phone (941) 255-5940

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1871542217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E OLYMPIA AVE",
            "address_2": "SUITE 212",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503833",
            "telephone_number": "941-255-5940",
            "fax_number": "941-255-5943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E OLYMPIA AVE",
            "address_2": "SUITE 212",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503833",
            "telephone_number": "941-255-5940",
            "fax_number": "941-255-5943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST ORTHOPEDIC & SPORTS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "941-255-5940",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT3524",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT2914",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "QK8",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "R6V",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S O S Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Punta Gorda, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.