NPIMap

Individual provider Active NPI

Jacqueline R Scofield, PT

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1629004536
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P8339 Issued in NC
Practice address
1025 Bullard CT Ste 105
Raleigh, NC 27615-6874
Phone
(919) 875-1932
Fax
(919) 875-1933
NPI assigned
Jun 23, 2006
Last updated
Mar 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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 002230 WV
Physical Therapist 225100000X P8339 NC Primary

Addresses

Primary practice location

1025 Bullard CT Ste 105
Raleigh, NC 27615-6874

Mailing address

1025 Bullard CT Ste 105
Raleigh, NC 27615-6874
Phone (919) 875-1932

Other names 1

  • Jacqueline M Roth Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
P8339NCMDPhysical Therapist
002230WVMDPhysical Therapist
8339NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Probility Therapy Services Physical Therapist PastSince Dec 9, 2004 Accepting new patients
Avante Physical Therapy Past Accepting new patients
Cary Orthopaedic and Sports Medicine Specialists, P.a. Past Accepting new patients
Proaxis Therapy SC, LLC Physical Therapist Past Accepting new patients
Probility Therapy Services Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1629004536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 BULLARD CT STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156874",
            "telephone_number": "919-875-1932",
            "fax_number": "919-875-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 BULLARD CT STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156874",
            "telephone_number": "919-875-1932",
            "fax_number": "919-875-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOFIELD",
        "first_name": "JACQUELINE",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "002230",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P8339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "ROTH",
            "middle_name": "M",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Mar 2, 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.

Verify at the official NPI Registry.