Individual provider Active NPI

Deborah Williams, PT

  • Pediatric Physical Therapist
  • Sanford, FL
National Provider Identifier
1982024063
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
16249 Issued in FL
Practice address
115 London Fog Way
Sanford, FL 32771-7760
Phone
(407) 314-2504
NPI assigned
Apr 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 16249 FL
Pediatric Physical Therapist 2251P0200X 16249 FL Primary

Addresses

Primary practice location

115 London Fog Way
Sanford, FL 32771-7760

Mailing address

115 London Fog Way
Sanford, FL 32771-7760
Phone (407) 314-2504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060118000872 FL Practitioner - Physical Therapist in Private Practice 1456375369 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16249FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speak Easy Solutions, LLC. Physical Therapy CurrentSince May 4, 2014 Accepting new patients
Complete Wellness Medical Center of Sanford, Inc. Physical Therapy PastSince Sep 6, 2010 Accepting new patients

Locations

901 Clark St
Oviedo, FL 32765
Phone (407) 359-5693

1809 E Broadway St
Oviedo, FL 32765
Phone (407) 359-5693

Organizations & group practices 2

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": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1982024063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LONDON FOG WAY",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717760",
            "telephone_number": "407-314-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LONDON FOG WAY",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717760",
            "telephone_number": "407-314-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DEBORAH",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "16249",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "16249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.