Active NPI
Charles Clifton Plumley, PTA
- Physical Therapy Assistant
- Longview, TX
National Provider Identifier
1477919900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2036978
- Practice address
- 3201 4TH St
Longview, TX 75605-5145 - Phone
- (903) 236-4291
- NPI assigned
- Jan 13, 2016
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2036978 | TX | Primary |
Addresses
Primary practice location
3201 4TH St
Longview, TX 75605-5145
Mailing address
1120 Rolling Hills Dr
Longview, TX 75604-2242
Phone (903) 736-1877
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 |
|---|---|---|---|
| 2036978 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453248000000",
"number": "1477919900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 ROLLING HILLS DR",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756042242",
"telephone_number": "903-736-1877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 4TH ST",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756055145",
"telephone_number": "903-236-4291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLUMLEY",
"first_name": "CHARLES",
"middle_name": "CLIFTON",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-13",
"last_updated": "2016-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2036978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.