Active NPI
Jessica Coltabaugh
- Physical Therapist
- Black Mountain, NC
National Provider Identifier
1114794476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P17717
- Practice address
- 200 Tabernacle Rd
Black Mountain, NC 28711-7733 - Phone
- (828) 669-6473
- NPI assigned
- Dec 7, 2023
- 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 | P17717 | NC | Primary |
Addresses
Primary practice location
200 Tabernacle Rd
Black Mountain, NC 28711-7733
Mailing address
2 Greenwood Rd
Asheville, NC 28803-3106
Phone (252) 723-8987
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 |
|---|---|---|---|
| P17717 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702339200000",
"number": "1114794476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 GREENWOOD RD",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288033106",
"telephone_number": "252-723-8987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 TABERNACLE RD",
"city": "BLACK MOUNTAIN",
"state": "NC",
"postal_code": "287117733",
"telephone_number": "828-669-6473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLTABAUGH",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-07",
"last_updated": "2023-12-12",
"certification_date": "2023-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P17717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Black Mountain, NC
- Cold Mountain Pharmacy Services
- Cold Mountain Pharmacy Services
- Cold Mountain Pharmacy Services L.L.C.
- Cold Mountain Pharmacy Services L.L.C.
- Karen B Collins, LPCA, LCAS-A, NCC
- Fred Allen Connelly, RPH
- Jennifer Renae Cook, FNP-BC
- Kelsey Lauren Crabtree, LCMHC
- Heather Rawls Cree, PHARM.D.
- D S Douglas Otr L LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.