Individual provider Active NPI

Steve Fell

  • Physical Therapy Clinic/Center
  • Saint Augustine, FL
National Provider Identifier
1902167992
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
27325 Issued in FL
Practice address
1690 US Highway 1 S
Suite a
Saint Augustine, FL 32084-4192
Phone
(904) 180-2101
Fax
(904) 810-2106
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 27325 FL Primary

Addresses

Primary practice location

1690 US Highway 1 S
Suite a
Saint Augustine, FL 32084-4192

Mailing address

1690 US Highway 1 S
Suite a
Saint Augustine, FL 32084-4192
Phone (904) 180-2101

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

LicenseStateTypeSpecialty
27325FLMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Medal Physical Therapy LLC Physical Therapy CurrentSince Oct 1, 2002 Accepting new patients
Performance Science and Rehab Physical Therapy Current Accepting new patients

Locations

407 E Churchville Rd
Ste 102
Bel Air, MD 21014
Phone (410) 529-2348

8640 Ridgelys Choice Dr
Ste L1
Nottingham, MD 21236
Phone (410) 529-0989

Organizations & group practices 2

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1902167992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 US HIGHWAY 1 S",
            "address_2": "SUITE A",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320844192",
            "telephone_number": "904-180-2101",
            "fax_number": "904-810-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 US HIGHWAY 1 S",
            "address_2": "SUITE A",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320844192",
            "telephone_number": "904-180-2101",
            "fax_number": "904-810-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELL",
        "first_name": "STEVE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "27325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.