Individual provider Active NPI

Craig Duggan, P.T.

  • Physical Therapist
  • Kernersville, NC
National Provider Identifier
1265756191
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P13983 Issued in NC
Practice address
1730 Kernersville Medical Pkwy Ste 201
Kernersville, NC 27284-7198
Phone
(336) 996-7001
NPI assigned
Mar 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P13983 NC Primary

Addresses

Primary practice location

1730 Kernersville Medical Pkwy Ste 201
Kernersville, NC 27284-7198

Mailing address

PO Box 601791
Charlotte, NC 28260-1791
Phone (336) 996-7001

Other practice location 1

170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (704) 323-2000

Other practice location 2

170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (704) 323-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cduggan164993@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121219000426 NC Practitioner - Physical Therapist in Private Practice 7113179110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P13983NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Specialists of the Carolinas, P.a. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cduggan164993@direct.novanthealth.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1265756191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791",
            "telephone_number": "336-996-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 KERNERSVILLE MEDICAL PKWY STE 201",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847198",
            "telephone_number": "336-996-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Kimel Park Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036946",
            "country_code": "US",
            "telephone_number": "704-323-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 Kimel Park Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036946",
            "country_code": "US",
            "telephone_number": "704-323-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUGGAN",
        "first_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-22",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P13983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cduggan164993@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "170 Kimel Park Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.