Wanda Lisa Crunkleton, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

604 Issued in NC

Practice address

1705 Tarboro St SW
Wilson, NC 27893-3428

Phone

(252) 399-8998

NPI assigned

Sep 8, 2018

Last updated

Sep 8, 2018By the provider in NPPES

Sex

Female

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": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536364800000",
    "number": "1093298804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 WATERY BRANCH CHURCH RD",
            "city": "STANTONSBURG",
            "state": "NC",
            "postal_code": "278839179",
            "telephone_number": "919-920-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933428",
            "telephone_number": "252-399-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUNKLETON",
        "first_name": "WANDA",
        "middle_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-08",
        "last_updated": "2018-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Craven, MD
• Shannon Crawford, CADC
• Erica Lynn Crouse, RPA-C
• Mary Katherine Crouse
• Jessica Massengill Crunkleton, PHARMD
• Alyson Anita Crush, MSW, LCSW
• Rhea Juanita Cruz, MSN APRN FNP-C
• Crystal R. Cox, DDS, Ms, PA (Signature Smiles Orthodontics)
• James Lee Cummings II, MD
• Nancy Kwamboka Cunningham

• Physical Therapy Assistant in Wilson, NC
• Providers in Wilson, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2018; 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.