Individual provider Active NPI

Ellen Mary Romay

  • Physical Therapist
  • Santa Rosa, CA
National Provider Identifier
1518512102
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18393 Issued in CA
Practice address
300 Fountaingrove Pkwy
Santa Rosa, CA 95403-5720
Phone
(707) 566-8600
NPI assigned
Aug 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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 18393 CA Primary

Addresses

Primary practice location

300 Fountaingrove Pkwy
Santa Rosa, CA 95403-5720

Mailing address

721 5TH St E
Sonoma, CA 95476-7225

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Arbolresidences

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
18393CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1518512102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 5TH ST E",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FOUNTAINGROVE PKWY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035720",
            "telephone_number": "707-566-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAY",
        "first_name": "ELLEN",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "18393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Arbolresidences",
            "affiliation": "N",
            "address_1": "300 Fountaingrove Pkwy",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954035720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.

Verify at the official NPI Registry.