Individual provider Active NPI

Megan Calungcaguin

  • Physical Therapist
  • Ponte Vedra, FL
National Provider Identifier
1376255398
Registry record updated Jan 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39106 Issued in FL
Practice address
465 Town Plaza Ave Ste B
Ponte Vedra, FL 32081-5190
Phone
(904) 222-3780
NPI assigned
Dec 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 39106 FL Primary

Addresses

Primary practice location

465 Town Plaza Ave Ste B
Ponte Vedra, FL 32081-5190

Mailing address

465 Town Plaza Ave Ste B
Ponte Vedra, FL 32081-5190
Phone (904) 222-3780

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
39106FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673136000000",
    "number": "1376255398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 TOWN PLAZA AVE STE B",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815190",
            "telephone_number": "904-222-3780",
            "fax_number": "904-306-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 TOWN PLAZA AVE STE B",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815190",
            "telephone_number": "904-222-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALUNGCAGUIN",
        "first_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2023-01-08",
        "certification_date": "2023-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "39106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.