Justin Charles Pfruender, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P12201 Issued in NC

Practice address

1100 S Stratford Rd Ste 523
Winston Salem, NC 27103-3217

Phone

(336) 765-4703

Fax

(336) 765-1396

NPI assigned

May 10, 2018

Sex

Male

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

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Breakthrough Physical Therapy Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1558598532
  Medicare reassignment NPD
• Breakthrough Physical Therapy

  • Physical Therapist
  • Morehead City, NC
  • NPI 1083937692
  NPD (past)

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1124517644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "502-882-9379",
            "fax_number": "502-805-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S STRATFORD RD STE 523",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033217",
            "telephone_number": "336-765-4703",
            "fax_number": "336-765-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFRUENDER",
        "first_name": "JUSTIN",
        "middle_name": "CHARLES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P12201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keven Pfenning, DPT
• Elizabeth Pflug, CRNA
• Thea Marie Pflum, PA
• Karen Pfotenhauer, ARNP
• Cheryl C Pfruender, PT, DPT, MTC
• Alice Phuong Quynh Pham, MD
• Jamie Pham, DO
• Quoc Pham
• Theresa Pham
• Daniel Duong Phan, M.D.

• Physical Therapist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.