Vannesa Joy Tarectecan Villegas

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT22906 Issued in FL

Practice address

410 W Gulf Atlantic Hwy
Wildwood, FL 34785-7301

Phone

(352) 259-2159

NPI assigned

Mar 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Access Therapies at Home

  • Non-Pharmacy Dispensing Site
  • Indianapolis, IN
  • NPI 1255364758
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1184748105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5980 W 71ST ST STE 201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781785",
            "telephone_number": "317-388-0800",
            "fax_number": "317-388-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W GULF ATLANTIC HWY",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347857301",
            "telephone_number": "352-259-2159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5980 W 71st St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462781785",
            "country_code": "US",
            "telephone_number": "317-388-0800",
            "fax_number": "317-388-0805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLEGAS",
        "first_name": "VANNESA JOY",
        "middle_name": "TARECTECAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22906",
            "primary": true
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "IN",
            "license": "05008245A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sivakumar Venkatachalam, DMD
• Courtney Vilimek, APRN
• Village Discount Pharmacy
• Village Foot & Ankle P a
• Villagegate Care Collective Corporation
• Visionary Eye Care of Central Florida, Inc
• Vizavee Urgent & Primary Care, LLC
• Kira Nicole Weaver, PHARM D.
• Shirley Webb, COTA
• Wellness by Physicians, Inc.

• Physical Therapist in Wildwood, FL
• Providers in Wildwood, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.