NPIMap

Organization Active NPI

Pro-Active Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Tampa, FL
National Provider Identifier
1881682078
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PRO-ACTIVE PHYSICAL THERAPY, INC.
Practice address
13801 Bruce B Downs Blvd
Suite 303
Tampa, FL 33613-3946
Phone
(813) 979-4819
Fax
(813) 975-8708
NPI assigned
Oct 11, 2005
Last updated
Apr 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Authorized official

Name
Ms. Deborah Hisamoto
Title
Practice Administrator
Phone
(813) 979-4819

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

13801 Bruce B Downs Blvd
Suite 303
Tampa, FL 33613-3946

Mailing address

13801 Bruce B Downs Blvd Ste 303
Tampa, FL 33613-3939
Phone (813) 979-4819

National Provider Directory

National Provider Directory

Locations

13801 Bruce B Downs Blvd
Ste 303
Tampa, FL 33613
Phone (813) 979-4819

Practitioners & affiliated clinicians

Practitioners 4

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": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522800000000",
    "number": "1881682078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD STE 303",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133939",
            "telephone_number": "813-979-4819",
            "fax_number": "813-975-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD",
            "address_2": "SUITE 303",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133946",
            "telephone_number": "813-979-4819",
            "fax_number": "813-975-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-ACTIVE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2018-04-04",
        "status": "A",
        "authorized_official_last_name": "HISAMOTO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "813-979-4819",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "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 Apr 4, 2018; 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.