Individual provider Active NPI

Jerri Boney, PT

  • Physical Therapist
  • Winston Salem, NC
National Provider Identifier
1720111909
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11005 Issued in NC
Practice address
1250 Arbor Rd
Winston Salem, NC 27104-1106
Phone
(336) 724-7921
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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 11005 NC Primary

Addresses

Primary practice location

1250 Arbor Rd
Winston Salem, NC 27104-1106

Mailing address

834 Madison Place Cir
Kernersville, NC 27284-7754
Phone (336) 993-5536

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210111000988 NC Practitioner - Physical Therapist in Private Practice 4981017084 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Nov 8, 2020 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Nov 8, 2020 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 9, 2023 Accepting new patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Oct 9, 2023 Accepting new patients

Locations

2701 Pickett Rd
Durham, NC 27705
Phone (919) 419-4012

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

2147 Davie Ave
Statesville, NC 28625
Phone (704) 878-0123

Organizations & group practices 4

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1720111909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 MADISON PLACE CIR",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847754",
            "telephone_number": "336-993-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 ARBOR RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271041106",
            "telephone_number": "336-724-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONEY",
        "first_name": "JERRI",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "11005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.