Individual provider Active NPI

Simmonette Ponferrada Libre-Sabio, PT

  • Physical Therapist
  • Blue Bell, PA
National Provider Identifier
1669597985
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT010043L Issued in PA
Practice address
8000 Twin Silo Dr
Blue Bell, PA 19422-4200
Phone
(215) 699-8727
Fax
(215) 699-2568
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT010043L PA Primary

Addresses

Primary practice location

8000 Twin Silo Dr
Blue Bell, PA 19422-4200

Mailing address

4242 N Gorski LN
Collegeville, PA 19426-4120
Phone (215) 699-8727

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
PT010043LPAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669597985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4242 N GORSKI LN",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194264120",
            "telephone_number": "215-699-8727",
            "fax_number": "215-699-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 TWIN SILO DR",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194224200",
            "telephone_number": "215-699-8727",
            "fax_number": "215-699-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBRE-SABIO",
        "first_name": "SIMMONETTE",
        "middle_name": "PONFERRADA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT010043L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

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

Verify at the official NPI Registry.