NPIMap

Individual provider Active NPI

Juanita Leann Staton, P.T.

  • Physical Therapist
  • Huntsville, AL
National Provider Identifier
1124120704
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH4831 Issued in AL
Practice address
1267 Enterprise Way NW Ste B
Huntsville, AL 35806-4472
Phone
(256) 713-1872
Fax
(256) 713-1873
NPI assigned
Sep 2, 2006
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4184 MS
Physical Therapist 225100000X PTH4831 AL Primary

Addresses

Primary practice location

1267 Enterprise Way NW Ste B
Huntsville, AL 35806-4472

Mailing address

1267 Enterprise Way NW Ste B
Huntsville, AL 35806-4472
Phone (256) 713-1872

Other identifiers 2

IdentifierTypeStateIssuer
PTH4831OtherALPHYSICAL THERAPIST LICENS
PT4184OtherMSMISSSISSIPPI STATE BOARD OF PHYSICAL THERAPY

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
PT4184MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthactions PA Physical Therapist Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Decatur Orthopaedic Clinic, LLC Past Accepting new patients
Ms Medical Supplies, Inc. Past Accepting new patients

Organizations & group practices 4

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1124120704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1267 ENTERPRISE WAY NW STE B",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358064472",
            "telephone_number": "256-713-1872",
            "fax_number": "256-713-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 ENTERPRISE WAY NW STE B",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358064472",
            "telephone_number": "256-713-1872",
            "fax_number": "256-713-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "JUANITA",
        "middle_name": "LEANN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT4184",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH4831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST LICENS",
            "identifier": "PTH4831",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSSISSIPPI STATE BOARD OF PHYSICAL THERAPY",
            "identifier": "PT4184",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.