Purpose Physical Therapy – Orthopedic Physical Therapist, NPI 1003422064

Purpose Physical Therapy is a healthcare provider. based in St petersburg, Florida. specializing in Orthopedic Physical Therapist. The NPI Number for Purpose Physical Therapy is 1003422064

Main info

Organization
Name
Purpose Physical Therapy
NPI
1003422064
Phone
(417) 315-5777
Address
6619 1ST AVE S
Authorized Official
DR. KENNETH JOHN CLARK JR. OWNER/CEO DPT
Enumeration Date
16 September 2020
Last Update Date
15 November 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness80
Years active:5State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Purpose Physical Therapy

  • 6619 1ST AVE S

    ST PETERSBURG, FL 337071305

    Phone: (417) 315-5777

    Type: Location

  • 1190 28TH AVE N UNIT 1/2

    ST PETERSBURG, FL 337042523

    Phone: (417) 315-5577

    Type: Mailing

  • 3369 10TH ST N

    ST PETERSBURG, FL 337041205

    Phone: (417) 315-5577

    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: 2023-03-03

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
O20230303000851OPhysical/Occupational Therapy Group In Private PracticeFLTBD

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 33707)

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Reviews

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Frequently asked questions

What number should I use to identify Purpose Physical Therapy for billing?
Administrative and clinical systems typically use NPI 1003422064 for Purpose Physical Therapy.
Is Purpose Physical Therapy currently accepting referrals based on NPI status?
Registry metadata lists Purpose Physical Therapy as active.
What services align with Purpose Physical Therapy's listing?
Purpose Physical Therapy's public classification highlights Orthopedic Physical Therapist. Clinical services aligned with this taxonomy classification.
What city is tied to Purpose Physical Therapy?
The directory associates Purpose Physical Therapy with St Petersburg, Florida. Check all listed addresses for suites or satellite offices.
Can I export Purpose Physical Therapy's record?
You can download the official NPPES record; we summarize key fields for readability.

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