Individual provider Active NPI

Asher Reuel Roberts

  • Physical Therapist
  • Winston Salem, NC
National Provider Identifier
1497597215
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24314 Issued in NC
Practice address
1901 Mooney St
Winston Salem, NC 27103-3027
Phone
(336) 716-8091
Fax
(336) 716-9253
NPI assigned
Jun 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P24314 NC Primary
Physical Therapist 225100000X 29948 MD

Addresses

Primary practice location

1901 Mooney St
Winston Salem, NC 27103-3027

Mailing address

1901 Mooney St
Winston Salem, NC 27103-3027
Phone (336) 716-8091

Other practice location 1

1341 Hughes Ford Rd Ste 104
Frederick, MD 21701-3134
Phone (301) 798-4838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260122002002 NC Practitioner - Physical Therapist in Private Practice 4880132695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

1901 Mooney St
Winston Salem, NC 27103-3027
Phone (336) 716-8091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29948MDMDPhysical Therapist
P24314NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences Physical Therapist CurrentSince Sep 22, 2025 Accepting new patients

Locations

1030 Mall Loop Rd
High Point, NC 27262
Phone (336) 781-4320

4515 Premier Dr
Ste 307
High Point, NC 27265
Phone (336) 802-2250

1901 Mooney St
Winston Salem, NC 27103
Phone (336) 716-8091

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1497597215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MOONEY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033027",
            "telephone_number": "336-716-8091",
            "fax_number": "336-716-9253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MOONEY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033027",
            "telephone_number": "336-716-8091",
            "fax_number": "336-716-9253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1341 Hughes Ford Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217013134",
            "country_code": "US",
            "telephone_number": "301-798-4838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ASHER",
        "middle_name": "REUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24314",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.