Individual provider Active NPI

Jerry Deer

  • Physical Therapy Assistant
  • Valrico, FL
National Provider Identifier
1902347925
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 27145 Issued in FL
Practice address
810 Innergary PL
Valrico, FL 33594-4167
Phone
(863) 327-7170
NPI assigned
Mar 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 27145 FL Primary

Addresses

Primary practice location

810 Innergary PL
Valrico, FL 33594-4167

Mailing address

810 Innergary PL
Valrico, FL 33594-4167
Phone (863) 327-7170

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA 27145FLMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1902347925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 INNERGARY PL",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335944167",
            "telephone_number": "863-327-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 INNERGARY PL",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335944167",
            "telephone_number": "863-327-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEER",
        "first_name": "JERRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 27145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.