1174540512 NPI number — DUNN PHYSICAL THERAPY INC

Table of content: (NPI 1174540512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174540512 NPI number — DUNN PHYSICAL THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DUNN PHYSICAL THERAPY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174540512
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
221 WESTON ESTATES WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27560-6989
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-417-1147
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
981 HIGH HOUSE RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
CARY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27513-3510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-388-0111
Provider Business Practice Location Address Fax Number:
919-388-8668
Provider Enumeration Date:
07/15/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DUNN
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
919-417-1147

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 665DPYM . This is a "UHC ACN MPN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 685426 . This is a "UHC ACN MPN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 01935 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7210398 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7211681 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".