Henry Allen Gockenbach, P.T., A.T.C

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT19109 Issued in FL

Practice address

3761 SW Wycoff St
Port Saint Lucie, FL 34953-5318

Phone

(772) 532-1834

Fax

(772) 464-3365

NPI assigned

Jun 1, 2006

Last updated

Jan 27, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201392000000",
    "number": "1881631653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3761 SW WYCOFF ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535318",
            "telephone_number": "772-532-1834",
            "fax_number": "772-464-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3761 SW WYCOFF ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535318",
            "telephone_number": "772-532-1834",
            "fax_number": "772-464-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOCKENBACH",
        "first_name": "HENRY",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "P.T., A.T.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19109",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL1142",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2008; 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.