Individual provider Active NPI

Phoung Haboon McCarthy, P.T.A.

  • Contractor
  • Saint Petersburg, FL
National Provider Identifier
1265664767
Registry record updated Aug 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
225100000X Issued in FL
Practice address
3721 36TH St N
Saint Petersburg, FL 33713-1415
Phone
(727) 501-6326
NPI assigned
Aug 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 225100000X FL Primary

Addresses

Primary practice location

3721 36TH St N
Saint Petersburg, FL 33713-1415

Mailing address

3721 36TH St N
Saint Petersburg, FL 33713-1415
Phone (727) 501-6326

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
225100000XFLMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250467200000",
    "number": "1265664767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 36TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337131415",
            "telephone_number": "727-501-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 36TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337131415",
            "telephone_number": "727-501-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "PHOUNG",
        "middle_name": "HABOON",
        "name_prefix": "Mrs.",
        "credential": "P.T.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2009-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "225100000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; 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.