Individual provider Active NPI

Joshua D Hefner, P.T.

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1639459829
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13190 Issued in NC
Practice address
3515 Glenwood Ave
Raleigh, NC 27612-4934
Phone
(919) 781-4060
Fax
(919) 781-5246
NPI assigned
Aug 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13190 NC Primary

Addresses

Primary practice location

3515 Glenwood Ave
Raleigh, NC 27612-4934

Mailing address

3515 Glenwood Ave
Raleigh, NC 27612-4934
Phone (919) 781-4060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110909002658 NC Practitioner - Physical Therapist in Private Practice 2769652346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Brody School of Medicine at East Carolina University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benson Sports Therapy and Wellness LLCGroup PAC ID 4284001728, 2 clinicians

Practice addresses (Care Compare)

300 E Church St
Benson, NC 27504-1555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13190NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benson Sports Therapy and Wellness, LLC Physical Therapist CurrentSince Oct 10, 2022 Accepting new patients

Locations

300 E Church St
Benson, NC 27504

300 E Church St
Ste 5
Benson, NC 27504
Phone (919) 701-1251

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": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1639459829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124934",
            "telephone_number": "919-781-4060",
            "fax_number": "919-781-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124934",
            "telephone_number": "919-781-4060",
            "fax_number": "919-781-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFNER",
        "first_name": "JOSHUA",
        "middle_name": "D",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "13190",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 7, 2013; 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.