Active NPI
Jessica Spruill, PTA
- Physical Therapy Assistant
- Edenton, NC
National Provider Identifier
1013175736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1288
- Practice address
- 1341 Paradise Rd
Edenton, NC 27932-8503 - Phone
- (252) 482-2538
- NPI assigned
- May 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1288 | NC | Primary |
Addresses
Primary practice location
1341 Paradise Rd
Edenton, NC 27932-8503
Mailing address
924 Old Cherry Rd
Creswell, NC 27928-9624
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1288 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1013175736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 OLD CHERRY RD",
"city": "CRESWELL",
"state": "NC",
"postal_code": "279289624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1341 PARADISE RD",
"city": "EDENTON",
"state": "NC",
"postal_code": "279328503",
"telephone_number": "252-482-2538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRUILL",
"first_name": "JESSICA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-29",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "1288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edenton, NC
- Laurie Halsey Simmons, LCSW
- Christopher Dewaine Smith, DC
- Susan Loraine Smoots, FNP
- Snapback NC, Co.
- Marvin Nelson Spear, PHARMD
- Sierra Swain, LCSW-A
- Robert Nathan Sykes Jr., PHARMACIST
- Tar River LTC Group, LLC (Chowan River Nursing and Rehabilitation Center)
- John Stafford Taylor, MD
- Joseph Gaston Taylor III, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.