Christy Tyquiengco, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306605280 Issued in VA

Practice address

3100 Shore Dr
Virginia Beach, VA 23451-1467

Phone

(800) 392-9187

NPI assigned

Jul 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Christy Tyquiengco Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1164030003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GRAVENHURST DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234648656",
            "telephone_number": "787-371-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SHORE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511467",
            "telephone_number": "800-392-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYQUIENGCO",
        "first_name": "CHRISTY",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306605280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTY",
            "last_name": "TYQUIENGCO",
            "prefix": "MS.",
            "credential": "CHRISTY TYQUIENGCO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Physical Therapy Assistant in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.

Verify at the official NPI Registry.