Individual provider Active NPI

Ritchie Mug Chenfoo

  • Physical Therapist
  • West Melbourne, FL
National Provider Identifier
1801508569
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29056 Issued in FL
Practice address
1054 Bryce LN
West Melbourne, FL 32904-8718
Phone
(321) 405-9043
NPI assigned
Dec 14, 2022
Last updated
Dec 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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 29056 FL Primary

Addresses

Primary practice location

1054 Bryce LN
West Melbourne, FL 32904-8718

Mailing address

1054 Bryce LN
West Melbourne, FL 32904-8718

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL nethealth

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
29056FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1801508569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 BRYCE LN",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329048718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 BRYCE LN",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329048718",
            "telephone_number": "321-405-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENFOO",
        "first_name": "RITCHIE",
        "middle_name": "MUG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "29056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "nethealth",
            "affiliation": "N",
            "address_1": "1054 Bryce Ln",
            "city": "West Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329048718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.