Individual provider Active NPI

Lynda-Jean Richardson, PTA

  • Physical Therapy Assistant
  • Fort Pierce, FL
National Provider Identifier
1992117907
Registry record updated May 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA18097 Issued in FL
Practice address
700 S 29TH St
Fort Pierce, FL 34947-3626
Phone
(772) 465-7560
Fax
(772) 465-5619
NPI assigned
May 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2014

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 PTA18097 FL Primary

Addresses

Primary practice location

700 S 29TH St
Fort Pierce, FL 34947-3626

Mailing address

700 S 29TH St
Fort Pierce, FL 34947-3626
Phone (772) 465-7560

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
PTA18097FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1400976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400976000000",
    "number": "1992117907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S 29TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349473626",
            "telephone_number": "772-465-7560",
            "fax_number": "772-465-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S 29TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349473626",
            "telephone_number": "772-465-7560",
            "fax_number": "772-465-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "LYNDA-JEAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-25",
        "last_updated": "2014-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA18097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2014; 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.