Charles Wright Northcutt IV, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2152450 Issued in TX

Practice address

1501 Holiday Dr.
Sulphur Springs, TX 75482-4707

Phone

(903) 335-8727

Fax

(903) 335-8217

NPI assigned

Feb 6, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• East Texas Physical Therapy

  • Physical Therapist
  • Sulphur Springs, TX
  • NPI 1629356787
  NPD

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1225660426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 RED OAK CIR.",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754824707",
            "telephone_number": "903-335-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HOLIDAY DR.",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754824707",
            "telephone_number": "903-335-8727",
            "fax_number": "903-335-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHCUTT",
        "first_name": "CHARLES",
        "middle_name": "WRIGHT",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2152450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Marie Newsom, FNP
• Kelly L Newsome, PNP
• Emily Ann Noble, PA-C
• Nocona Hospital District
• North Hopkins Isd
• Leslie A. Northcutt, PT, DPT
• Northeast Texas Home Health Agency, LTD
• NP Rhoades Inc PLLC
• Carlton E O'Neal, O.D.
• Mary Ann O'Neal, M.S.

• Physical Therapy Assistant in Sulphur Springs, TX
• Providers in Sulphur Springs, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.