MEDICARE: ORIGIN PHYSICAL THERAPY FL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1477220861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORIGIN PHYSICAL THERAPY FL PLLC

Provider Business Mailing Address
First Line	:	PO BOX 104341
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91189-3230
Country	:	US
Telephone Number	:	310-479-2323
Fax Number	:

Provider Business Practice Location Address
First Line	:	12411 HYMEADOW DRIVE
Second Line	:	BUILDING 3 SUITE 3B
City	:	AUSTIN
State	:	TX
Zip	:	78750-1874
Country	:	US
Telephone Number	:	512-335-9300
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH CATHERINE CLAMPETT
Credential	:	PT, DPT
Telephone Number	:	214-536-5401

Provider Enumeration Date	:	08/24/2021
Last Update Date	:	03/11/2026

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