Individual provider Active NPI

Michael Timothy Carter II

  • Home Modifications Contractor
  • Martinsville, VA
National Provider Identifier
1245822154
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
License
2705147295 Issued in VA
Practice address
880 N Fork Rd
Martinsville, VA 24112-1846
Phone
(276) 732-1986
NPI assigned
Feb 11, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X 2705147295 VA Primary

Addresses

Primary practice location

880 N Fork Rd
Martinsville, VA 24112-1846

Mailing address

880 N Fork Rd
Martinsville, VA 24112-1846
Phone (276) 732-1986

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

LicenseStateTypeSpecialty
2705147295VAMDHome Modifications Contractor

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1245822154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 N FORK RD",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241121846",
            "telephone_number": "276-732-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 N FORK RD",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241121846",
            "telephone_number": "276-732-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "VA",
            "license": "2705147295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.