Individual provider Active NPI

Jeri Marie McAliley, DPT

  • Physical Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1902074487
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 23863 Issued in FL
Practice address
600 Opp Dr
Fort Walton Beach, FL 32548-4493
Phone
(850) 301-1935
Fax
(850) 301-1937
NPI assigned
Feb 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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 PT 23863 FL Primary

Addresses

Primary practice location

600 Opp Dr
Fort Walton Beach, FL 32548-4493

Mailing address

600 Opp Dr
Fort Walton Beach, FL 32548-4493
Phone (850) 301-1935

Other names 1

  • Jeri Marie Hartzog Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080509000539 FL Practitioner - Physical Therapist in Private Practice 4981783354 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Rehab Management LLCGroup PAC ID 1951586890, 10 clinicians

Practice addresses (Care Compare)

249 Mack Bayou Loop
Suite 101
Santa Rosa Beach, FL 32459-7197
Phone (850) 622-0842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 23863FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PT Solutions of Pensacola, LLC Physical Therapist CurrentSince Apr 1, 2017 Accepting new patients
Premier Rehab Management, LLC Physical Therapist CurrentSince May 1, 2021 Accepting new patients
PT Solutions of Pensacola LLC Physical Therapist CurrentSince Apr 1, 2017 Accepting new patients
Bluewater Orthopedics PA CurrentSince Jun 18, 2017 Accepting new patients
Bluewater Orthopedics, P.a. CurrentSince Jun 18, 2017 Accepting new patients
White Sands Physical Therapy Inc Physical Therapist PastSince Oct 17, 2006 Accepting new patients

Locations

120 E Redstone Ave
Ste B
Crestview, FL 32539
Phone (850) 398-8600

8199 Navarre Pkwy
#12A
Navarre, FL 32566
Phone (850) 939-1233

1950 Bluewater Blvd
Ste 100
Niceville, FL 32578
Phone (850) 897-8081

5401 Corporate Woods Dr
Ste 300
Pensacola, FL 32504
Phone (850) 912-6840

249 Mack Bayou Loop
Ste 101
Santa Rosa Beach, FL 32459
Phone (850) 622-0842

1100 Circle 75 Pkwy SE
Ste 1400
Atlanta, GA 30339
Phone (678) 403-3555

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23855/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

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": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498694400000",
    "number": "1902074487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OPP DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484493",
            "telephone_number": "850-301-1935",
            "fax_number": "850-301-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 OPP DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484493",
            "telephone_number": "850-301-1935",
            "fax_number": "850-301-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCALILEY",
        "first_name": "JERI",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-18",
        "last_updated": "2017-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 23863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERI",
            "last_name": "HARTZOG",
            "middle_name": "MARIE",
            "credential": "DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; 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.