Bollettieri Sports Medicine Center

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BOLLETTIERI SPORTS MEDICINE CENTER

Practice address

5500 34TH Street West
Bradenton, FL 34210-3506

Phone

(941) 755-0068

Fax

(941) 727-7502

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Jay S Frye, PTNPI 1407155740

Title

Managing Partner

Phone

(941) 755-0068

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jay Steven Frye, DPT

  • Physical Therapist
  • Sarasota, FL
  • NPI 1407155740
  NPD (past) Authorized official

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1962574541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 34TH STREET WEST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103506",
            "telephone_number": "941-755-0068",
            "fax_number": "941-727-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 34TH STREET WEST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103506",
            "telephone_number": "941-755-0068",
            "fax_number": "941-727-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLLETTIERI SPORTS MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "FRYE",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "941-755-0068",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "Q3B",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "5864226-003",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jake Griffith Bohnenkamp, DC
• Alice Boican, MD
• Angela H. Bokelmann, M.A. CCC-SLP
• Norma Bolanos
• Morris S Bollegraf, D.O.
• Ashley Bolton, DPT
• Tammie Latisha Bolton
• Tamesha L Bombicino, CNM
• Debra Lynn Bonine, MA
• Adrienne Sue Bookhamer, LCSW

• Physical Therapy Clinic/Center in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.