Individual provider Active NPI

Kaitlyn Nicolle Wasson, DPT

  • Physical Therapist
  • Palm Harbor, FL
National Provider Identifier
1891306098
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4705 Alt 19 Ste a
Palm Harbor, FL 34683-1424
Phone
(727) 781-3550
Fax
(727) 781-3450
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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 Primary

Addresses

Primary practice location

4705 Alt 19 Ste a
Palm Harbor, FL 34683-1424

Mailing address

10754 Lakewood Shores Cir
North Fort Myers, FL 33903-6600
Phone (412) 720-3968

Other practice location 1

530 E Olympia Ave # 112
Punta Gorda, FL 33950-3838
Phone (941) 575-7300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826001282 FL Practitioner - Physical Therapist in Private Practice 0749607422 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fitness Quest - Venice LLCGroup PAC ID 9739125964, 44 clinicians

Practice addresses (Care Compare)

400 Tamiami TRL S
Suite 210
Venice, FL 34285-2626
Phone 87746937782004

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fitness Quest - Venice LLC Physical Therapist CurrentSince Feb 1, 2025 Accepting new patients
Fq0016, LLC Physical Therapist CurrentSince Jun 20, 2022 Accepting new patients
Florida Strong Physical Therapy LLC Physical Therapist CurrentSince Jan 16, 2023 Accepting new patients
Fq0014 Physical Therapist CurrentSince Sep 8, 2020 Accepting new patients
Fitness Quest-Port Charlotte LLC Physical Therapist CurrentSince Aug 12, 2020 Accepting new patients
Fitness Quest - Venice LLC CurrentSince Feb 1, 2025 Accepting new patients
Fitness Quest West Villages, LLC CurrentSince Aug 12, 2020 Accepting new patients
Fitness Quest - Bradenton LLC CurrentSince Aug 12, 2020 Accepting new patients
Fitness Quest - Punta Gorda LLC Physical Therapist CurrentSince Aug 12, 2020 Accepting new patients

Locations

3657 Cortez Rd W
Ste 110
Bradenton, FL 34210
Phone (941) 361-9020

2828 S McCall Rd
Ste 25
Englewood, FL 34224
Phone (941) 460-6174

11930 Fairway Lakes Dr
Fort Myers, FL 33913
Phone (239) 687-3224

11930 Fairway Lakes Dr
Ste 103104
Fort Myers, FL 33913
Phone (239) 687-3224

18900 N Tamiami Trl
Ste A5
North Ft Myers, FL 33903
Phone (239) 451-4922

11045 Tamiami Trl S
North Port, FL 34287
Phone (877) 469-3778

3479 Precision Dr
Ste 115
North Venice, FL 34275
Phone (941) 275-6377

1649 Tamiami Trl
Ste 1A
Pt Charlotte, FL 33948
Phone (941) 743-6700

530 E Olympia Ave
#112
Punta Gorda, FL 33950
Phone (941) 575-7300

530 E Olympia Ave
Ste 112
Punta Gorda, FL 33950
Phone (941) 575-7300

400 Tamiami Trl S
Ste 210
Venice, FL 34285
Phone (877) 469-3778

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 9

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": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1891306098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10754 LAKEWOOD SHORES CIR",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339036600",
            "telephone_number": "412-720-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 ALT 19 STE A",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831424",
            "telephone_number": "727-781-3550",
            "fax_number": "727-781-3450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 E Olympia Ave # 112",
            "address_purpose": "LOCATION",
            "city": "Punta Gorda",
            "state": "FL",
            "postal_code": "339503838",
            "country_code": "US",
            "telephone_number": "941-575-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSON",
        "first_name": "KAITLYN",
        "middle_name": "NICOLLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.