Active NPI
Paul Poretta
- Physical Therapy Assistant
- Mount Airy, NC
National Provider Identifier
1649549080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- Practice address
- 542 Allred Mill Rd
Mount Airy, NC 27030-2202 - Phone
- (336) 789-5076
- NPI assigned
- Dec 14, 2011
- 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 | Primary |
Addresses
Primary practice location
542 Allred Mill Rd
Mount Airy, NC 27030-2202
Mailing address
201 Normandy Dr
Wilmington, NC 28412-7920
Phone (978) 618-0044
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538524800000",
"number": "1649549080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 NORMANDY DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284127920",
"telephone_number": "978-618-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "542 ALLRED MILL RD",
"city": "MOUNT AIRY",
"state": "NC",
"postal_code": "270302202",
"telephone_number": "336-789-5076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORETTA",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-14",
"last_updated": "2018-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Airy, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.