Active NPI
Richard Michael Guthrie, PT
- Physical Therapist
- Camp Lejeune, NC
National Provider Identifier
1417931783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9163
- Practice address
- 100 Brewster Blvd
Camp Lejeune, NC 28547-2538 - Phone
- (910) 450-4136
- Fax
- (910) 450-4558
- NPI assigned
- Dec 1, 2005
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225100000X | 9163 | NC | Primary |
Addresses
Primary practice location
100 Brewster Blvd
Camp Lejeune, NC 28547-2538
Mailing address
100 Brewster Blvd
Camp Lejeune, NC 28547-2538
Phone (910) 450-4136
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 079J9 | Other | NC | BCBS |
| 09214 | Other | NC | MEDCOST |
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 |
|---|---|---|---|
| 9163 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239494400000",
"number": "1417931783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 BREWSTER BLVD",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "285472538",
"telephone_number": "910-450-4136",
"fax_number": "910-450-4558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BREWSTER BLVD",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "285472538",
"telephone_number": "910-450-4136",
"fax_number": "910-450-4558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTHRIE",
"first_name": "RICHARD",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-01",
"last_updated": "2009-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "9163",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "079J9",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "09214",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Camp Lejeune, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.