Individual provider Active NPI

Dawn Briley Roberson, PTA

  • Physical Therapy Assistant
  • Greenville, NC
National Provider Identifier
1033368030
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2223 Issued in NC
Practice address
102 Staton CT Ste F
Greenville, NC 27834-9076
Phone
(252) 758-9907
Fax
(252) 758-9908
NPI assigned
Sep 15, 2008
Last updated
Sep 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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 2223 NC Primary

Addresses

Primary practice location

102 Staton CT Ste F
Greenville, NC 27834-9076

Mailing address

102 Staton CT Ste F
Greenville, NC 27834-9076
Phone (252) 758-9907

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
2223NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Therapy of North Carolina Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1033368030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 STATON CT STE F",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278349076",
            "telephone_number": "252-758-9907",
            "fax_number": "252-758-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 STATON CT STE F",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278349076",
            "telephone_number": "252-758-9907",
            "fax_number": "252-758-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "DAWN",
        "middle_name": "BRILEY",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "2223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.

Verify at the official NPI Registry.