Individual provider Active NPI

Chelsea Moore Fulford

  • Physical Therapist
  • Saint Petersburg, FL
National Provider Identifier
1861645343
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT19226 Issued in FL
Practice address
5088 66TH St N
Saint Petersburg, FL 33709-3120
Phone
(727) 541-2675
NPI assigned
Oct 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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 PT19226 FL Primary

Addresses

Primary practice location

5088 66TH St N
Saint Petersburg, FL 33709-3120

Mailing address

7000 W Camino Real
Suite 240
Boca Raton, FL 33433-5532
Phone (561) 417-9563

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT19226FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Medical Inc Physical Therapist Past Accepting new patients
Cardiothoracic Surgery of Hyde Park Inc Past Accepting new patients
Trinity 5 Inc Physical Therapist PastSince Jul 5, 2020 Accepting new patients
Physical Therapy in Your Home Inc Past Accepting new patients

Organizations & group practices 4

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": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1861645343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 W CAMINO REAL",
            "address_2": "SUITE 240",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335532",
            "telephone_number": "561-417-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5088 66TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337093120",
            "telephone_number": "727-541-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE FULFORD",
        "first_name": "CHELSEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.