Individual provider Active NPI

Gregory Antal, PT

  • Physical Therapist
  • Marion, NC
National Provider Identifier
1649585167
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12720 Issued in NC
Practice address
348 Grace Corpening Dr
Marion, NC 28752
Phone
(828) 580-6821
Fax
(828) 580-6822
NPI assigned
Aug 9, 2010
Last updated
Aug 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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 12720 NC Primary

Addresses

Primary practice location

348 Grace Corpening Dr
Marion, NC 28752

Mailing address

348 Grace Corpening Dr
Marion, NC 28752-5864
Phone (828) 580-6821

Other identifiers 1

IdentifierTypeStateIssuer
1649585167MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180910002687 NC Practitioner - Physical Therapist in Private Practice 2365792579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12720NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Jan 27, 2020 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Past Accepting new patients

Locations

348 Grace Corpening Dr
Marion, NC 28752
Phone (828) 580-6821

Organizations & group practices 3

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": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1649585167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 GRACE CORPENING DR",
            "city": "MARION",
            "state": "NC",
            "postal_code": "287525864",
            "telephone_number": "828-580-6821",
            "fax_number": "828-580-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 GRACE CORPENING DR",
            "city": "MARION",
            "state": "NC",
            "postal_code": "28752",
            "telephone_number": "828-580-6821",
            "fax_number": "828-580-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTAL",
        "first_name": "GREGORY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-09",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "12720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649585167",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.