Gary Richard Higginbotham II, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P10052 Issued in NC

Practice address

300 Blue Ridge St
Martinsville, VA 24112-7261

Phone

(276) 632-1249

NPI assigned

Feb 12, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1013249200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 BARTON CT",
            "city": "COLFAX",
            "state": "NC",
            "postal_code": "272359624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BLUE RIDGE ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241127261",
            "telephone_number": "276-632-1249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Barton Ct",
            "address_purpose": "LOCATION",
            "city": "Colfax",
            "state": "NC",
            "postal_code": "272359624",
            "country_code": "US",
            "telephone_number": "336-423-3015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "GARY",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P10052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Martinsville, VA
• Providers in Martinsville, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.