Individual provider Active NPI

William James Duncan IV, PT, DPT

  • Physical Therapist
  • Roswell, GA
National Provider Identifier
1083040802
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011219 Issued in GA
Practice address
48 King St Ste a
Roswell, GA 30075-4440
Phone
(678) 640-4606
Fax
(770) 993-9518
NPI assigned
Sep 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011219 GA Primary

Addresses

Primary practice location

48 King St Ste a
Roswell, GA 30075-4440

Mailing address

48 King St Ste a
Roswell, GA 30075-4440
Phone (678) 640-4606

Other practice location 1

209 Towne Lake Pkwy
Woodstock, GA 30188-4841
Phone (678) 640-4606

Other practice location 2

540 W Crossville Rd Ste 203
Roswell, GA 30075
Phone (678) 585-0175

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011219GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1083040802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 KING ST STE A",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300754440",
            "telephone_number": "678-640-4606",
            "fax_number": "770-993-9518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 KING ST STE A",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300754440",
            "telephone_number": "678-640-4606",
            "fax_number": "770-993-9518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Towne Lake Pkwy",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301884841",
            "country_code": "US",
            "telephone_number": "678-640-4606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 W Crossville Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "30075",
            "country_code": "US",
            "telephone_number": "678-585-0175",
            "fax_number": "678-585-7483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-25",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.

Verify at the official NPI Registry.