Individual provider Active NPI

William P. Sorrels, PT

  • Physical Therapist
  • Wilson, NC
National Provider Identifier
1710938824
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2351 Issued in NC
Practice address
1811 Forest Hills Rd W
Wilson, NC 27893-3412
Phone
(252) 243-7400
Fax
(252) 243-3291
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2351 NC
Physical Therapist 225100000X 2351 NC Primary

Addresses

Primary practice location

1811 Forest Hills Rd W
Wilson, NC 27893-3412

Mailing address

1811 Forest Hills Rd W
Wilson, NC 27893-3412
Phone (252) 243-7400

Other identifiers 3

IdentifierTypeStateIssuer
7211802MedicaidNC
078MCOtherNCBCBS
562280901OtherNCTAX ID #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031217001033 NC Practitioner - Physical Therapist in Private Practice 6204731714 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2351NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsboro Physical Therapy & Wellness Physical Therapist CurrentSince Jun 2, 2016 Accepting new patients
Comprehensive Rehab of Wilson, Inc. Physical Therapist Past Accepting new patients
William Pickens Sorrels Jr Physical Therapist Past Accepting new patients

Locations

2503 Wayne Memorial Dr
Goldsboro, NC 27534
Phone (919) 734-1311

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1710938824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 FOREST HILLS RD W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933412",
            "telephone_number": "252-243-7400",
            "fax_number": "252-243-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 FOREST HILLS RD W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933412",
            "telephone_number": "252-243-7400",
            "fax_number": "252-243-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORRELS",
        "first_name": "WILLIAM",
        "middle_name": "P.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "2351",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "2351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211802",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "078MC",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "562280901",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.