Individual provider Active NPI

Jordan Lindblom, PT, DPT

  • Physical Therapist
  • St Petersburg, FL
National Provider Identifier
1972148559
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
35261 Issued in FL
Practice address
8424 4TH St N Ste B
St Petersburg, FL 33702-3654
Phone
(813) 575-0427
NPI assigned
Nov 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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 35261 FL Primary

Addresses

Primary practice location

8424 4TH St N Ste B
St Petersburg, FL 33702-3654

Mailing address

3603 E Knollwood St
Tampa, FL 33610-1629
Phone (727) 455-5532

Other practice location 1

710 94th Ave N Ste 310
St Petersburg, FL 33702-2452
Phone (813) 575-0427

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
35261FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pelvic Balance Physical Therapy Physical Therapist CurrentSince Jul 31, 2023 Accepting new patients
Ekren Physical Therapy Services Inc PastSince Nov 1, 2019 Accepting new patients
Nalin LLC Physical Therapist PastSince Nov 1, 2019 Accepting new patients

Locations

710 94th Ave N
Ste 310
St Petersburg, FL 33702
Phone (414) 982-9173

8424 4th St N
Ste B
St Petersburg, FL 33702
Phone (813) 575-0427

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1972148559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3603 E KNOLLWOOD ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336101629",
            "telephone_number": "727-455-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 4TH ST N STE B",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337023654",
            "telephone_number": "813-575-0427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 94th Ave N Ste 310",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337022452",
            "country_code": "US",
            "telephone_number": "813-575-0427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINDBLOM",
        "first_name": "JORDAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "35261",
            "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 Jul 27, 2023; 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.