Active NPI
Mackenzie Tubbs, PT, DPT.
- Physical Therapist
- St Petersburg, FL
National Provider Identifier
1962396762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 43063
- Practice address
- 4201 31St St S
St Petersburg, FL 33712-4051 - Phone
- (727) 867-1104
- NPI assigned
- Jun 5, 2025
- 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 | 43063 | FL | Primary |
Addresses
Primary practice location
4201 31St St S
St Petersburg, FL 33712-4051
Mailing address
1911 W Aileen St
Tampa, FL 33607-2021
Phone (607) 483-8881
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
| License | State | Type | Specialty |
|---|---|---|---|
| 43063 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749081600000",
"number": "1962396762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1911 W AILEEN ST",
"city": "TAMPA",
"state": "FL",
"postal_code": "336072021",
"telephone_number": "607-483-8881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 31ST ST S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337124051",
"telephone_number": "727-867-1104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUBBS",
"first_name": "MACKENZIE",
"credential": "PT, DPT.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-05",
"last_updated": "2025-06-05",
"certification_date": "2025-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "43063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.