Individual provider Active NPI

Calvin Luther Gavilan Lagman, PT

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1942631148
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1238640 Issued in TX
Practice address
12124 High Tech Ave Ste 300
Orlando, FL 32817-8374
Phone
(800) 774-7785
NPI assigned
Dec 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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 1238640 TX Primary

Addresses

Primary practice location

12124 High Tech Ave Ste 300
Orlando, FL 32817-8374

Mailing address

2101 Harvey Mitchell Pkwy S
Apartment 204
College Station, TX 77840-5257
Phone (979) 481-7029

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230925000572 TX Practitioner - Physical Therapist in Private Practice 5991159048 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phil&Neet Enterprises LLC Physical Therapist CurrentSince Aug 21, 2023 Accepting new patients
Inspire Physical Therapy CurrentSince May 28, 2024 Accepting new patients

Locations

3030 E 29th St
Ste 119
Bryan, TX 77802
Phone (979) 721-4225

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": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1942631148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HARVEY MITCHELL PKWY S",
            "address_2": "APARTMENT 204",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778405257",
            "telephone_number": "979-481-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12124 HIGH TECH AVE STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328178374",
            "telephone_number": "800-774-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGMAN",
        "first_name": "CALVIN LUTHER",
        "middle_name": "GAVILAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1238640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.