Active NPI
Venus Fortin Penuliar-Chupuico, RPT
- Physical Therapist
- Warsaw, MO
National Provider Identifier
1144551516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2005036212
- Practice address
- 1238 Commercial St
Warsaw, MO 65355-3157 - Phone
- (660) 438-2876
- NPI assigned
- Jan 24, 2010
- Last updated
- Jan 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 2005036212 | MO | Primary |
Addresses
Primary practice location
1238 Commercial St
Warsaw, MO 65355-3157
Mailing address
611 E Oak St
Clinton, MO 64735-1671
Phone (417) 396-6371
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005036212 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264291200000",
"number": "1144551516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 E OAK ST",
"city": "CLINTON",
"state": "MO",
"postal_code": "647351671",
"telephone_number": "417-396-6371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1238 COMMERCIAL ST",
"city": "WARSAW",
"state": "MO",
"postal_code": "653553157",
"telephone_number": "660-438-2876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENULIAR-CHUPUICO",
"first_name": "VENUS",
"middle_name": "FORTIN",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-24",
"last_updated": "2010-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2005036212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.