Active NPI
Paula Sprague, PT
- Physical Disabilities Residential Treatment Facility
- Raleigh, NC
National Provider Identifier
1538533492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Disabilities Residential Treatment Facility
- License
- 02180
- Practice address
- 3001 Spring Forest Rd
Raleigh, NC 27616-2815 - Phone
- (386) 447-4114
- NPI assigned
- Nov 16, 2015
- Sex
- Female
- 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 Disabilities Residential Treatment Facility | 320700000X | 02180 | MO | Primary |
Addresses
Primary practice location
3001 Spring Forest Rd
Raleigh, NC 27616-2815
Mailing address
1096 Keystone Trail Dr
Chesterfield, MO 63005-4265
Phone (314) 494-5890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02180 | Other | MO | LICENSE |
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 |
|---|---|---|---|
| 02180 | MO | MD | Physical Disabilities Residential Treatment Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1538533492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1096 KEYSTONE TRAIL DR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630054265",
"telephone_number": "314-494-5890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 SPRING FOREST RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162815",
"telephone_number": "386-447-4114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRAGUE",
"first_name": "PAULA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-16",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": "MO",
"license": "02180",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "02180",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.