OrganizationActive
Intentional Play, Inc
NPI 1063957298 · Pediatric Physical Therapist · Jacksonville, FL
Provider details
- NPI number
- 1063957298
- Entity type
- Organization
- Primary specialty
- Pediatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Krisitn Owen, President(904) 434-5673
- License
- PT6722 (FL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4712 Marsh Hammock Dr W
Jacksonville, FL 32224-1858
Phone: (904) 434-5673
Street-level locationGet directions
Mailing address
4712 Marsh Hammock Dr W
Jacksonville, FL 32224-1858
Other names (DBA / former)
- Doing business as
- Intentional Play Pediatric Therapy Services
Registry dates
- Enumerated
- 2016-12-26
- Last updated
- 2016-12-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.