Individual provider Active NPI

Madonna R Agcaoili

  • Physical Therapist
  • Pelham, AL
National Provider Identifier
1881922334
Registry record updated Nov 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1690 Issued in AR
Practice address
245 Cahaba Valley Pkwy
Pelham, AL 35124-2216
Phone
(205) 942-6820
Fax
(205) 942-5884
NPI assigned
Nov 20, 2009
Last updated
Nov 20, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2009

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 1690 AR Primary

Addresses

Primary practice location

245 Cahaba Valley Pkwy
Pelham, AL 35124-2216

Mailing address

3100 N Old Missouri Rd
Fayetteville, AR 72703-4415

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
1690ARMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1881922334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 N OLD MISSOURI RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CAHABA VALLEY PKWY",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242216",
            "telephone_number": "205-942-6820",
            "fax_number": "205-942-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGCAOILI",
        "first_name": "MADONNA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "1690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.