Individual provider Active NPI

Denise Colette Futrell, LPTA

  • Physical Therapy Assistant
  • Winston Salem, NC
National Provider Identifier
1649303819
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1777 Issued in NC
Practice address
1250 Arbor Rd
Winston Salem, NC 27104-1106
Phone
(336) 724-7921
Fax
(336) 724-0499
NPI assigned
Mar 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1777 NC Primary

Addresses

Primary practice location

1250 Arbor Rd
Winston Salem, NC 27104-1106

Mailing address

3155 Stone Forest Dr
Winston Salem, NC 27105-8759
Phone (336) 727-9997

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

LicenseStateTypeSpecialty
1777NCMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649303819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 STONE FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271058759",
            "telephone_number": "336-727-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 ARBOR RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271041106",
            "telephone_number": "336-724-7921",
            "fax_number": "336-724-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUTRELL",
        "first_name": "DENISE",
        "middle_name": "COLETTE",
        "name_prefix": "Mrs.",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "1777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

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.

Verify at the official NPI Registry.