Individual provider Active NPI

Pamela Ouellette

  • Physical Therapy Assistant
  • Ft Lauderdale, FL
National Provider Identifier
1992927644
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA18566 Issued in FL
Practice address
3201 W Commercial Blvd Ste 116
Ft Lauderdale, FL 33309-3431
Phone
(866) 212-9086
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PTA18566 FL Primary

Addresses

Primary practice location

3201 W Commercial Blvd Ste 116
Ft Lauderdale, FL 33309-3431

Mailing address

1840 Rawdon St NW
Palm Bay, FL 32907-8513

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
PTA18566FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992927644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 RAWDON ST NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329078513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W COMMERCIAL BLVD STE 116",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093431",
            "telephone_number": "866-212-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA18566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, 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.

Verify at the official NPI Registry.