Individual provider Active NPI

Richard Allen Imhoff, RPT

  • Physical Therapist
  • Panama City, FL
National Provider Identifier
1154682193
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT23771 Issued in FL
Practice address
1931 Martin Luther King Jr Blvd
Panama City, FL 32405-5314
Phone
(850) 215-7093
Fax
(850) 215-7096
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT23771 FL Primary

Addresses

Primary practice location

1931 Martin Luther King Jr Blvd
Panama City, FL 32405-5314

Mailing address

1931 Martin Luther King Jr Blvd
Panama City, FL 32405-5314
Phone (850) 215-7093

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

LicenseStateTypeSpecialty
PT23771FLMDPhysical Therapist
1052LAMDHearing Instrument Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1154682193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 MARTIN LUTHER KING JR BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324055314",
            "telephone_number": "850-215-7093",
            "fax_number": "850-215-7096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 MARTIN LUTHER KING JR BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324055314",
            "telephone_number": "850-215-7093",
            "fax_number": "850-215-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMHOFF",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT23771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.