Organization Active NPI

St. Pete Physical Therapy

  • Physical Therapy Clinic/Center
  • St Petersburg, FL
National Provider Identifier
1992402846
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ST. PETE PHYSICAL THERAPY
Practice address
11210 Blue Heron Blvd
St Petersburg, FL 33716
Phone
(727) 490-9487
NPI assigned
Feb 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Authorized official

Name
Jan Schorpion, DPTNPI 1639451891
Title
Owner, Doctor of Physical Therapy
Phone
(727) 490-9487

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

11210 Blue Heron Blvd
St Petersburg, FL 33716

Mailing address

3642 Bayshore Blvd NE
St Petersburg, FL 33703-5514
Phone (908) 872-0621

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address janschorpion@stpetept.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230329002155 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9830563055 Receives reassigned benefits from 7 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

11210 Blue Heron Blvd N
St Petersburg, FL 33716
Phone (727) 222-5765

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1992402846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3642 BAYSHORE BLVD NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337035514",
            "telephone_number": "908-872-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11210 BLUE HERON BLVD",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33716",
            "telephone_number": "727-490-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-04",
        "status": "A",
        "authorized_official_last_name": "SCHORPION",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "OWNER, DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "727-490-9487",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "janschorpion@stpetept.com",
            "affiliation": "N",
            "address_1": "11210 Blue Heron Blvd",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 10, 2023; 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.