Maggie Marie Petty, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P11905 Issued in NC

Practice address

4140 Ramsey St Ste 110
Fayetteville, NC 28311-7658

Phone

(910) 920-4903

Fax

(910) 920-4910

NPI assigned

Sep 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Breakthrough Physical Therapy

  • Physical Therapist
  • Morehead City, NC
  • NPI 1083937692
  NPD (past)
• Breakthrough Physical Therapy Inc

  • Physical Therapist
  • Fayetteville, NC
  • NPI 1285958348
  NPD (past)

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1396227401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 HIGH HOUSE RD STE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133510",
            "telephone_number": "919-388-0111",
            "fax_number": "919-388-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 RAMSEY ST STE 110",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283117658",
            "telephone_number": "910-920-4903",
            "fax_number": "910-920-4910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2332 Lebanon Pike",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372142411",
            "country_code": "US",
            "telephone_number": "615-690-9760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTY",
        "first_name": "MAGGIE",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P11905",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rocco Petruolo, R N
• Audrey Petteruti, DO
• Josie Lynn Pettipiece, MS, CCC-SLP
• Natifa Pettus, LCSW
• Angela D Petty, LMFT
• Emily Becker Pevtsov, PA-C
• Yonesha Val Phair, D.D.S
• My Pham, PHARMD
• Telisa Dawn Pharris, MSW, LCSWA, LCASA
• Phases Recovery Community PLLC

• Physical Therapist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.