Individual provider Active NPI

Patrick H. Demoss, P.T.

  • Physical Therapist
  • Lakeland, FL
National Provider Identifier
1972707149
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT31383 Issued in FL
Practice address
1583 Royal Forest CT
Lakeland, FL 33811-3124
Phone
(719) 761-8393
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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 PT31383 FL Primary

Addresses

Primary practice location

1583 Royal Forest CT
Lakeland, FL 33811-3124

Mailing address

1583 Royal Forest CT
Lakeland, FL 33811-3124
Phone (719) 761-8393

Other practice location 1

1330 Quail Lake Loop
Ste 100
Colorado Springs, CO 80906-4651
Phone (719) 579-0230

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
PT31383FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1972707149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1583 ROYAL FOREST CT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338113124",
            "telephone_number": "719-761-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1583 ROYAL FOREST CT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338113124",
            "telephone_number": "719-761-8393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Quail Lake Loop",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809064651",
            "country_code": "US",
            "telephone_number": "719-579-0230",
            "fax_number": "719-579-0277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMOSS",
        "first_name": "PATRICK",
        "middle_name": "H.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT31383",
            "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 Sep 25, 2019; 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.