Active NPI
Tracy Caroline Guadamuz, PT
- Physical Therapist
- Newport, AR
National Provider Identifier
1104020064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- AR2329
- Practice address
- 1205 McLain St
Newport, AR 72112-3533 - Phone
- (870) 523-0191
- Fax
- (870) 523-0195
- NPI assigned
- Jun 13, 2007
- 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 | AR2329 | AR | Primary |
Addresses
Primary practice location
1205 McLain St
Newport, AR 72112-3533
Mailing address
PO Box 1321
State University, AR 72467-1321
Phone (870) 930-0209
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 |
|---|---|---|---|
| AR2329 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104020064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1321",
"city": "STATE UNIVERSITY",
"state": "AR",
"postal_code": "724671321",
"telephone_number": "870-930-0209",
"fax_number": "870-934-8277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 MCLAIN ST",
"city": "NEWPORT",
"state": "AR",
"postal_code": "721123533",
"telephone_number": "870-523-0191",
"fax_number": "870-523-0195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUADAMUZ",
"first_name": "TRACY",
"middle_name": "CAROLINE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "AR2329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.