Active NPI
Jennifer Gonzalez Flicker, MSPT
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1659454726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9963
- Practice address
- 2709 Blue Ridge Rd
Suite 200
Raleigh, NC 27607-6462 - Phone
- (919) 784-4685
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- 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 | 9963 | NC | Primary |
Addresses
Primary practice location
2709 Blue Ridge Rd
Suite 200
Raleigh, NC 27607-6462
Mailing address
305 Glen Bonnie LN
Cary, NC 27511-5463
Phone (919) 467-1229
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 |
|---|---|---|---|
| 9963 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659454726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 GLEN BONNIE LN",
"city": "CARY",
"state": "NC",
"postal_code": "275115463",
"telephone_number": "919-467-1229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2709 BLUE RIDGE RD",
"address_2": "SUITE 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276076462",
"telephone_number": "919-784-4685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLICKER",
"first_name": "JENNIFER",
"middle_name": "GONZALEZ",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "9963",
"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 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.