Active NPI
James Ethan Burgess, PT, DPT
- Physical Therapist
- Wilkesboro, NC
National Provider Identifier
1225595358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P20904
- Practice address
- 1016 Fletcher St
Wilkesboro, NC 28697-9472 - Phone
- (336) 667-9261
- NPI assigned
- Feb 25, 2019
- Last updated
- Mar 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8863 | TN | |
| Physical Therapist | 225100000X | P20904 | NC | Primary |
Addresses
Primary practice location
1016 Fletcher St
Wilkesboro, NC 28697-9472
Mailing address
1935 Old Highway 60
Millers Creek, NC 28651-8179
Phone (828) 773-2421
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 |
|---|---|---|---|
| P20904 | NC | MD | Physical Therapist |
| 8863 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1225595358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1935 OLD HIGHWAY 60",
"city": "MILLERS CREEK",
"state": "NC",
"postal_code": "286518179",
"telephone_number": "828-773-2421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 FLETCHER ST",
"city": "WILKESBORO",
"state": "NC",
"postal_code": "286979472",
"telephone_number": "336-667-9261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "JAMES",
"middle_name": "ETHAN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-25",
"last_updated": "2022-03-21",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "8863",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P20904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkesboro, NC
- Bethany Medical Center
- Lynda Black, PHD, LPC
- Blue Ridge Speech, LLC.
- Allison Brame, M.S., OTR/L
- Deborah Sue Bufkin, PTA
- Jennifer Lynn Burgess, LMFT
- Kevin James Byrd, QP
- Zoee Amber Wood Byrd, LCMHC
- Jami Lynn Cantrell, LPC
- Carrigan & Associates Counseling Inc (Main Street Station Psycho Social Rehabilitation)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.