Brian Cloninger

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A5690 Issued in NC

Practice address

3101 Duraleigh Rd
Raleigh, NC 27612-4189

Phone

(615) 613-1956

NPI assigned

Sep 23, 2019

Last updated

Sep 23, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1477104206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 BARNARD CASTLE CT",
            "city": "ROLESVILLE",
            "state": "NC",
            "postal_code": "275719716",
            "telephone_number": "615-613-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 DURALEIGH RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124189",
            "telephone_number": "615-613-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLONINGER",
        "first_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A5690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard B Clinton, MD
• Hailey Smith Clissold, PA-C
• Reynolds Clodfelter, Jr.
• Kerry Michelle Clodfelter, LCMHCA
• Rebecca Jeffries Cloer, FNP
• Tracey S Cloninger, PA-C
• Kristie Reynolds Clontz, FNP-C
• Charles A Cloutier, M.D.
• Christina Clyburn, FNLP
• Clyde E. Croom, OD, PA

• Physical Therapy Assistant in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.