Active NPI
Darryl Mel Ence, PHYSICAL THERAPIST
- Physical Therapist
- Fort Benning, GA
National Provider Identifier
1639263627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 77949
- Practice address
- 7950 Martin Loop
BLD 9200
Fort Benning, GA 31905-5647 - Phone
- (706) 544-4495
- Fax
- (706) 544-2022
- NPI assigned
- Oct 3, 2006
- 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 Therapist | 225100000X | 77949 | GA | Primary |
Addresses
Primary practice location
7950 Martin Loop
BLD 9200
Fort Benning, GA 31905-5647
Mailing address
4684 Woodmere LN
Columbus, GA 31907-7016
Phone (706) 442-9227
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 |
|---|---|---|---|
| 77949 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639263627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4684 WOODMERE LN",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319077016",
"telephone_number": "706-442-9227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7950 MARTIN LOOP",
"address_2": "BLD 9200",
"city": "FORT BENNING",
"state": "GA",
"postal_code": "319055647",
"telephone_number": "706-544-4495",
"fax_number": "706-544-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENCE",
"first_name": "DARRYL",
"middle_name": "MEL",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "77949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Benning, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.