Active NPI
Eric Renshaw, PTA
- Physical Therapy Assistant
- Durham, NC
National Provider Identifier
1689122178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 6079
- Practice address
- 3420 Holloway St
Durham, NC 27703-3522 - Phone
- (919) 596-9464
- NPI assigned
- Sep 14, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 6079 | NC | Primary |
Addresses
Primary practice location
3420 Holloway St
Durham, NC 27703-3522
Mailing address
3420 Holloway St
Durham, NC 27703-3522
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 |
|---|---|---|---|
| 6079 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473811200000",
"number": "1689122178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3420 HOLLOWAY ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277033522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3420 HOLLOWAY ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277033522",
"telephone_number": "919-596-9464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENSHAW",
"first_name": "ERIC",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-14",
"last_updated": "2016-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "6079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
- Samantha Lucia Reneau, MSW, LCSWA, LCASA
- Renee Gaskey-Foley, D.D.S., P.a.
- Sarah Renema
- Renewed Mind Behavioral Health, PLLC
- Katelyn Elizabeth Rennyson
- Tracy L Rentner, R.N.C-F.N.P
- Julie Anne Reo, PT
- Research Triangle Counseling PLLC
- Research Triangle Occupational Health Services, PA
- Reset Therapeutic Group, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.