Individual provider Active NPI

Lettitia Marie Fey, PTA

  • Physical Therapy Assistant
  • Ormond Beach, FL
National Provider Identifier
1780997486
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA22172 Issued in FL
Practice address
1275 W. Granada Blvd
Suite 4B2
Ormond Beach, FL 32174
Phone
(386) 615-1112
NPI assigned
Jul 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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 PTA22172 FL Primary

Addresses

Primary practice location

1275 W. Granada Blvd
Suite 4B2
Ormond Beach, FL 32174

Mailing address

1275 W. Granada Blvd
Suite 4B2
Ormond Beach, FL 32174
Phone (386) 615-1112

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
PTA22172FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cora Health Services, Inc Past Accepting new patients
Cora Health Services Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1780997486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 W. GRANADA BLVD",
            "address_2": "SUITE 4B2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-615-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 W. GRANADA BLVD",
            "address_2": "SUITE 4B2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-615-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEY",
        "first_name": "LETTITIA",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA22172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.