EMILY VICKERS (PT, DPT, PCS) – Pediatric Physical Therapist, NPI 1194139741

EMILY VICKERS (PT, DPT, PCS) is a healthcare provider. based in Crestview, Florida. specializing in Pediatric Physical Therapist. They hold the professional credentials PT, DPT, PCS. They hold a License No. 004841 (IA). The NPI Number for EMILY VICKERS (PT, DPT, PCS) is 1194139741

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
EMILY VICKERS (PT, DPT, PCS)
NPI
1194139741
Phone
(850) 682-8388
Address
4100 S Ferdon Blvd
Enumeration Date
11 June 2014
Last Update Date
16 June 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5632414230
Graduation Year
2007 (19 years ago)
PAC ID
5395093041
Group Practice PAC ID
0840289633
Professional Enrollment ID
I20180813001223
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for EMILY VICKERS (PT, DPT, PCS)

  • 4100 S Ferdon Blvd

    Ste A-1

    Crestview, FL 325365252

    Phone: (850) 682-8388

    Fax: (850) 682-7463

    Type: Location

  • 4401 E Colonial Dr

    Orlando, FL 328035200

    Phone: (407) 898-5060

    Fax: (407) 898-5185

    Type: Location

  • 1377 11TH ST NW

    CLINTON, IA 527325068

    Phone: (563) 241-4230

    Fax: (563) 519-4235

    Type: Location

  • 583 WOODLAND DR

    CLINTON, IA 527323620

    Phone: (615) 308-5193

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-08-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180813001223IPhysical Therapist In Private PracticeIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32536)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840289633View full group profile
NameSpecialtyState
-IA
Qualified Speech Language PathologistIA
Qualified Speech Language PathologistIA
-IA
-IA
-IA
-IA
-IA
Physical Therapist In Private PracticeIA

Reviews

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Frequently asked questions

What identifier follows EMILY VICKERS (PT, DPT, PCS) across health systems?
The NPI 1194139741 uniquely identifies EMILY VICKERS (PT, DPT, PCS) in U.S. healthcare data.
Quick check: is EMILY VICKERS (PT, DPT, PCS) active?
Public NPPES data shows EMILY VICKERS (PT, DPT, PCS) with an active NPI status right now.
What type of care does EMILY VICKERS (PT, DPT, PCS) provide?
EMILY VICKERS (PT, DPT, PCS)'s profile centers on Pediatric Physical Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to EMILY VICKERS (PT, DPT, PCS)?
EMILY VICKERS (PT, DPT, PCS) shows a connection to Crestview, Florida in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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