Individual provider Active NPI

Geoffrey Gitau Ngugi

  • Physical Therapy Assistant
  • Salem, VA
National Provider Identifier
1508369893
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306602788 Issued in VA
Practice address
3615 W Main St
Salem, VA 24153-1961
Phone
(540) 380-4500
NPI assigned
Mar 13, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306602788 VA Primary

Addresses

Primary practice location

3615 W Main St
Salem, VA 24153-1961

Mailing address

2507 Marr St NW
Roanoke, VA 24012-7201

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
2306602788VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1508369893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 MARR ST NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240127201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241531961",
            "telephone_number": "540-380-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUGI",
        "first_name": "GEOFFREY",
        "middle_name": "GITAU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306602788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.