Active NPI
Justin Lee Ternes
- Orthopedic Physical Therapist
- Bentonville, AR
National Provider Identifier
1376069401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT293492
- 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, 2024
- 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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PT293492 | AR | MD | Orthopedic 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.