Active NPI
Michael Reno Norris, PTA
- Physical Therapy Assistant
- Roxboro, NC
National Provider Identifier
1265637730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2949
- Practice address
- 901 Ridge Rd
Roxboro, NC 27573-4511 - Phone
- (336) 599-4030
- Fax
- (336) 599-4030
- NPI assigned
- Jun 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2949 | NC | Primary |
Addresses
Primary practice location
901 Ridge Rd
Roxboro, NC 27573-4511
Mailing address
4800 Little Falls Dr
Raleigh, NC 27609-5900
Phone (919) 787-4072
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 |
|---|---|---|---|
| 2949 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265637730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 LITTLE FALLS DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276095900",
"telephone_number": "919-787-4072",
"fax_number": "336-599-4030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 RIDGE RD",
"city": "ROXBORO",
"state": "NC",
"postal_code": "275734511",
"telephone_number": "336-599-4030",
"fax_number": "336-599-4030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORRIS",
"first_name": "MICHAEL",
"middle_name": "RENO",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "2949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roxboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.