Active NPI
Joel Matthew Burgess, PTA
- Physical Therapy Assistant
- Salisbury, NC
National Provider Identifier
1598070815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1877
- Practice address
- 1504 Kentucky St
Salisbury, NC 28144-6500 - Phone
- (704) 762-0340
- Fax
- (704) 762-0340
- NPI assigned
- Aug 11, 2010
- 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 Therapy Assistant | 225200000X | 1877 | NC | Primary |
Addresses
Primary practice location
1504 Kentucky St
Salisbury, NC 28144-6500
Mailing address
68 Global Dr
Suite 100
Greenville, SC 29607-4628
Phone (864) 644-2700
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 |
|---|---|---|---|
| 1877 | NC | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| X-Tra Performance & Physical Therapy Company | Past | Accepting new patients |
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.
-
- Physical Therapy Clinic/Center
- Salisbury, NC
- NPI 1538468665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312848000000",
"number": "1598070815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 GLOBAL DR",
"address_2": "SUITE 100",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296074628",
"telephone_number": "864-644-2700",
"fax_number": "864-644-2709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1504 KENTUCKY ST",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281446500",
"telephone_number": "704-762-0340",
"fax_number": "704-762-0340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "JOEL",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-11",
"last_updated": "2011-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "1877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.