Active NPI
Rachel Andie Simon Proulx, MPT
- Pediatric Physical Therapist
- Orlando, FL
National Provider Identifier
1346202611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT17836
- Practice address
- 8003 Rural Retreat CT
Orlando, FL 32819-3917 - Phone
- (407) 234-2301
- Fax
- (407) 264-9724
- NPI assigned
- Apr 3, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT17836 | FL | Primary |
Addresses
Primary practice location
8003 Rural Retreat CT
Orlando, FL 32819-3917
Mailing address
8003 Rural Retreat CT
Orlando, FL 32819-3917
Phone (407) 234-2301
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 |
|---|---|---|---|
| PT17836 | FL | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1346202611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8003 RURAL RETREAT CT",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328193917",
"telephone_number": "407-234-2301",
"fax_number": "407-264-9724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8003 RURAL RETREAT CT",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328193917",
"telephone_number": "407-234-2301",
"fax_number": "407-264-9724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROULX",
"first_name": "RACHEL",
"middle_name": "ANDIE SIMON",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "FL",
"license": "PT17836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.