Active NPI
Pamela Goodridge
- Physical Therapist
- Kissimmee, FL
National Provider Identifier
1811005994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 501 E Oak St Ste D
Kissimmee, FL 34744-4554 - Phone
- (407) 847-9110
- NPI assigned
- Aug 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
501 E Oak St Ste D
Kissimmee, FL 34744-4554
Mailing address
1434 Oak Leaf LN
Kissimmee, FL 34744-2840
Phone (407) 933-2218
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT8590 | Other | FL | LICENSE # |
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
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811005994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1434 OAK LEAF LN",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347442840",
"telephone_number": "407-933-2218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 E OAK ST STE D",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347444554",
"telephone_number": "407-847-9110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODRIDGE",
"first_name": "PAMELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "PT8590",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, 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.