Individual provider Active NPI

Justin Lee Ternes

  • Orthopedic Physical Therapist
  • Bentonville, AR
National Provider Identifier
1376069401
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT293492 Issued in AR
Practice address
302 NW B St Apt 1
Bentonville, AR 72712-5219
Phone
(479) 466-3032
NPI assigned
Aug 21, 2017
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT293492 AR Primary

Addresses

Primary practice location

302 NW B St Apt 1
Bentonville, AR 72712-5219

Mailing address

302 NW B St Apt 1
Bentonville, AR 72712-5219
Phone (479) 466-3032

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
PT293492ARMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1376069401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 NW B ST APT 1",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125219",
            "telephone_number": "479-466-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 NW B ST APT 1",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125219",
            "telephone_number": "479-466-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERNES",
        "first_name": "JUSTIN",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AR",
            "license": "PT293492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.