Individual provider Active NPI

Dominiek Denise Schelfaut, PT

  • Mechanotherapist
  • South Pasadena, FL
National Provider Identifier
1780895961
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
PT 11375 Issued in FL
Practice address
1615 Pasadena Ave S
South Pasadena, FL 33707-4516
Phone
(727) 341-7636
NPI assigned
May 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
Mechanotherapist 172M00000X PT 11375 FL Primary

Addresses

Primary practice location

1615 Pasadena Ave S
South Pasadena, FL 33707-4516

Mailing address

7602 141St St
Seminole, FL 33776-3705
Phone (727) 391-0404

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
PT 11375FLMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1180224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780895961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7602 141ST ST",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337763705",
            "telephone_number": "727-391-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 PASADENA AVE S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337074516",
            "telephone_number": "727-341-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELFAUT",
        "first_name": "DOMINIEK",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "FL",
            "license": "PT 11375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, FL

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.