Individual provider Active NPI

Robin Stark, LPTA

  • Physical Therapy Assistant
  • Winter Park, FL
National Provider Identifier
1952784233
Registry record updated Jul 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA23301 Issued in FL
Practice address
550 W Morse Blvd
Winter Park, FL 32789-4206
Phone
(407) 644-6634
NPI assigned
Jul 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2015

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 PTA23301 FL Primary

Addresses

Primary practice location

550 W Morse Blvd
Winter Park, FL 32789-4206

Mailing address

2703 Nan Dr
Ocoee, FL 34761-8633
Phone (407) 218-3184

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
PTA23301FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435881600000",
    "number": "1952784233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 NAN DR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347618633",
            "telephone_number": "407-218-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W MORSE BLVD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894206",
            "telephone_number": "407-644-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "ROBIN",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-03",
        "last_updated": "2015-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2015; 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.