Active NPI
Juan Titherington
- Physical Therapy Assistant
- Vero Beach, FL
National Provider Identifier
1962684670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA18633
- Practice address
- 1705 17TH Ave
Vero Beach, FL 32960-3641 - Phone
- (772) 562-6877
- NPI assigned
- Dec 4, 2007
- Last updated
- Dec 4, 2007
- Sex
- Male
- 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 Therapy Assistant | 225200000X | PTA18633 | FL | Primary |
Addresses
Primary practice location
1705 17TH Ave
Vero Beach, FL 32960-3641
Mailing address
5709 Seagrape Dr
Fort Pierce, FL 34982-3228
Phone (772) 464-9866
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 |
|---|---|---|---|
| PTA18633 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1962684670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5709 SEAGRAPE DR",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349823228",
"telephone_number": "772-464-9866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 17TH AVE",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329603641",
"telephone_number": "772-562-6877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TITHERINGTON",
"first_name": "JUAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-04",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA18633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
- Alana Tingen, MS, OTR/L
- Julie Barker Tinsley, LCSW
- Nicholas E Tisdale, MD
- Titheotokos, LLC (Sunshine Pharmacy)
- Titheotokos, LLC (Sunshine Pharmacy)
- Subhash R Tiwari, MD
- TJM Home Health Care (Champion Home Health Care)
- TMC Transport, Inc
- TMS Therapeutic Services, LLC (TMS Provider Services of America)
- Lilliam Torre Tobar, PH.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.