Active NPI
Tarra Ann Wardrup, DPT, CSCS
- Physical Therapist
- Fort Lauderdale, FL
National Provider Identifier
1902116809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT26940
- Practice address
- 811 SE 26TH Ave
Fort Lauderdale, FL 33301-2711 - Phone
- (423) 737-3363
- NPI assigned
- Oct 14, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT26940 | FL | Primary |
Addresses
Primary practice location
811 SE 26TH Ave
Fort Lauderdale, FL 33301-2711
Mailing address
1514 Sheridan Rd
Apt 1417
Atlanta, GA 30324
Phone (423) 737-3363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT26940 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576800000000",
"number": "1902116809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 SHERIDAN RD",
"address_2": "APT 1417",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30324",
"telephone_number": "423-737-3363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 SE 26TH AVE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333012711",
"telephone_number": "423-737-3363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARDRUP",
"first_name": "TARRA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "DPT, CSCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-14",
"last_updated": "2019-12-20",
"certification_date": "2019-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT26940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.