Individual provider Active NPI

Jonathan Michael Belk, DPT

  • Physical Therapist
  • Fayetteville, NC
National Provider Identifier
1730547381
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P16142 Issued in NC
Practice address
4140 Ramsey St
Suite 111
Fayetteville, NC 28311-7672
Phone
(910) 920-4903
Fax
(910) 920-4910
NPI assigned
Feb 10, 2016
Last updated
Feb 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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 P16142 NC Primary

Addresses

Primary practice location

4140 Ramsey St
Suite 111
Fayetteville, NC 28311-7672

Mailing address

981 High House Rd
Suite 100
Cary, NC 27513-3510
Phone (919) 388-0111

Other identifiers 1

IdentifierTypeStateIssuer
P16142OtherNCNC STATE LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
P16142NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthrough Physical Therapy Physical Therapist Past Accepting new patients
Breakthrough Physical Therapy Inc Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1730547381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 HIGH HOUSE RD",
            "address_2": "SUITE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133510",
            "telephone_number": "919-388-0111",
            "fax_number": "919-388-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 RAMSEY ST",
            "address_2": "SUITE 111",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283117672",
            "telephone_number": "910-920-4903",
            "fax_number": "910-920-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELK",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P16142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "P16142",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.

Verify at the official NPI Registry.