Active NPI
Angela Marie Cicchino, DPT
- Physical Therapist
- St Augustine, FL
National Provider Identifier
1003440041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT35544
- Practice address
- 1 University Blvd
St Augustine, FL 32086-5799 - Phone
- (904) 829-3411
- Fax
- (904) 829-3412
- NPI assigned
- Feb 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT35544 | FL | Primary |
Addresses
Primary practice location
1 University Blvd
St Augustine, FL 32086-5799
Mailing address
1 University Blvd
St Augustine, FL 32086-5799
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT35544 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582848000000",
"number": "1003440041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 UNIVERSITY BLVD",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 UNIVERSITY BLVD",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865799",
"telephone_number": "904-829-3411",
"fax_number": "904-829-3412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICCHINO",
"first_name": "ANGELA",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-28",
"last_updated": "2020-02-28",
"certification_date": "2020-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT35544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.