BRENTON LATTA DPT
NPI 1083081731
Physical Therapist in Jacksonville, FL

Active since August 28, 2015
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: April 8, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 8, 2026, Nov 15, 2016 (2 updates tracked since 2016).

About Brenton Latta Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRENTON LATTA DPT (NPI 1083081731) is an individual physical therapist in Jacksonville, Florida, licensed in Florida (PT30630) and active in the NPI registry since August 2015. He is a graduate of Other (2015).

NPPES Registry Identity

NPI1083081731
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameBRENTON LATTACredential: DPT
Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865
Mailing AddressPo Box 860912Minneapolis, MN 55486-0912
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateAugust 28, 2015
Last NPPES UpdateApril 8, 20262 updates tracked since enumeration
NPPES CertifiedApril 8, 2026
✔ NPI 1083081731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in FL · PT30630
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
4500 SAN PABLO RD S, Jacksonville, FL 32224

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brenton Latta Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2264711084
PECOS Enrollment IDI20260323003076

Medicare Billing Reassignment

Medicare enrollment records show Brenton Latta reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Health Service
4500 SAN PABLO RD S
Jacksonville, FL 32224
  • Reassigned Medicare billing, Florida enrollment
  • 1,828 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Internal Medicine (Gastroenterology)
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Orthopaedic Surgery
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Internal Medicine
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Hospitalist
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brenton Latta's NPI number?

The NPI number for Brenton Latta is 1083081731. It was assigned to this individual provider in the NPPES registry on August 28, 2015.

Where is Brenton Latta located?

Brenton Latta practices at 4500 San Pablo Rd S, Jacksonville, FL 32224. The listed phone number is (904) 953-2000.

What is Brenton Latta's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Brenton Latta enrolled in Medicare?

Yes. Brenton Latta is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Brenton Latta's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brenton Latta reassigns Medicare benefits to Mayo Clinic Jacksonville (Jacksonville, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brenton Latta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brenton Latta accept?

Health plans from Sanford Health Plan list Brenton Latta as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brenton Latta was last updated on April 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.