Active NPI
Vibeth Jude Vicher-Vesagas, PHYSICAL THERAPIST
- Physical Therapist
- Saint Johns, FL
National Provider Identifier
1215400056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8254
- Practice address
- 813 S Bridgestone Ave
Saint Johns, FL 32259-7926 - Phone
- (904) 535-7775
- NPI assigned
- Jan 4, 2019
- Last updated
- Jan 4, 2019
- 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 | 8254 | FL | Primary |
Addresses
Primary practice location
813 S Bridgestone Ave
Saint Johns, FL 32259-7926
Mailing address
813 S Bridgestone Ave
Saint Johns, FL 32259-7926
Phone (904) 535-7775
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 |
|---|---|---|---|
| 8254 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546560000000",
"number": "1215400056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 S BRIDGESTONE AVE",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322597926",
"telephone_number": "904-535-7775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 S BRIDGESTONE AVE",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322597926",
"telephone_number": "904-535-7775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICHER-VESAGAS",
"first_name": "VIBETH",
"middle_name": "JUDE",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-04",
"last_updated": "2019-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "8254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Johns, FL
- Shelly Vann, LAT, ATC
- Adriana Marie Vargas-Acevedo, BS
- Amanda Taylor Vaughn, RBT
- Viviana Smith Vazquez, MD
- Isabel Amelia Velez Guzman, BEHAVIOR TECHNICIAN
- Wal-Mart Stores East , LP (Walmart Vision Center 30-0928)
- Wal-Mart Stores East, LP (Walmart Pharmacy 10-0928)
- Talisha Karen Walker, FNP
- Natalie Ward
- Terese Mary Warner, CRNA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.