Individual provider Active NPI

Jean Vano Budlong, PT

  • Physical Therapist
  • Lakeland, FL
National Provider Identifier
1962547349
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 0010900 Issued in FL
Practice address
3133 Lakeland Hills Blvd Ste 1-2
Lakeland, FL 33805-2208
Phone
(863) 603-0515
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT 0010900 FL Primary

Addresses

Primary practice location

3133 Lakeland Hills Blvd Ste 1-2
Lakeland, FL 33805-2208

Mailing address

605 Hunters Run Blvd
Lakeland, FL 33809-6658
Phone (863) 858-9346

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PT 0010900FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Physical Therapy, Inc. Physical Therapist CurrentSince Jul 1, 2013 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962547349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 HUNTERS RUN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338096658",
            "telephone_number": "863-858-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 LAKELAND HILLS BLVD STE 1-2",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052208",
            "telephone_number": "863-603-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDLONG",
        "first_name": "JEAN",
        "middle_name": "VANO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 0010900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.