Individual provider Active NPI

Scott J Killam, PT

  • Physical Therapist
  • Venice, FL
National Provider Identifier
1881710358
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7539 Issued in FL
Practice address
744 The Rialto
Venice, FL 34285-3524
Phone
(941) 484-5500
Fax
(941) 484-5510
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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 PT7539 FL Primary

Addresses

Primary practice location

744 The Rialto
Venice, FL 34285-3524

Mailing address

744 The Rialto
Venice, FL 34285-3524
Phone (941) 484-5500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111227000318 FL Practitioner - Physical Therapist in Private Practice 8921210709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Handworks Therapy LCGroup PAC ID 1951316264, 6 clinicians

Practice addresses (Care Compare)

744 The Rialto
Venice, FL 34285-3524
Phone (941) 484-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Handworks Therapy, L.C. Physical Therapist CurrentSince Jul 1, 2000 Accepting new patients

Locations

1503 S McCall Rd
Englewood, FL 34223
Phone (941) 475-5880

14283 Tamiami Trl
North Port, FL 34287
Phone (941) 423-5576

2616 Bee Ridge Rd
Sarasota, FL 34239
Phone (941) 927-6862

744 The Rialto
Venice, FL 34285
Phone (941) 484-5500

Organizations & group practices 1

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1881710358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 THE RIALTO",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853524",
            "telephone_number": "941-484-5500",
            "fax_number": "941-484-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 THE RIALTO",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853524",
            "telephone_number": "941-484-5500",
            "fax_number": "941-484-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLAM",
        "first_name": "SCOTT",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT7539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.