Active NPI
Caroline Torres Villagomez, DPT
- Physical Therapist
- Winston Salem, NC
National Provider Identifier
1053813311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17759
- Practice address
- 1903 S Hawthorne Rd
Winston Salem, NC 27103-3916 - Phone
- (336) 718-6700
- NPI assigned
- Mar 2, 2018
- 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 Therapist | 225100000X | 17759 | NC | Primary |
Addresses
Primary practice location
1903 S Hawthorne Rd
Winston Salem, NC 27103-3916
Mailing address
PO Box 601791
Charlotte, NC 28260-1791
Other practice location 1
865 W Lake Dr
Mount Airy, NC 27030-2157
Phone (336) 719-6100
Other practice location 2
865 W Lake Dr
Mount Airy, NC 27030-2157
Phone (336) 719-6100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cvillagomez537604@direct.novanthealth.org |
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 |
|---|---|---|---|
| 17759 | NC | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1053813311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601791",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1903 S HAWTHORNE RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271033916",
"telephone_number": "336-718-6700"
}
],
"practiceLocations": [
{
"address_1": "865 W Lake Dr",
"address_purpose": "LOCATION",
"city": "Mount Airy",
"state": "NC",
"postal_code": "270302157",
"country_code": "US",
"telephone_number": "336-719-6100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "865 W Lake Dr",
"address_purpose": "LOCATION",
"city": "Mount Airy",
"state": "NC",
"postal_code": "270302157",
"country_code": "US",
"telephone_number": "336-719-6100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VILLAGOMEZ",
"first_name": "CAROLINE",
"middle_name": "TORRES",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-02",
"last_updated": "2020-10-26",
"certification_date": "2020-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "17759",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cvillagomez537604@direct.novanthealth.org",
"affiliation": "N",
"address_1": "865 W Lake Dr",
"city": "Mount Airy",
"state": "NC",
"country_code": "US",
"postal_code": "270302157",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.