Active NPI
Wadsworth Duane Roy III
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1740462092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 553
- Practice address
- 3000 New Bern Ave
Raleigh, NC 27610-1231 - Phone
- (919) 350-7989
- Fax
- (919) 350-7130
- NPI assigned
- Nov 28, 2007
- Last updated
- Nov 28, 2007
- Sex
- Male
- 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 | 553 | NC | Primary |
Addresses
Primary practice location
3000 New Bern Ave
Raleigh, NC 27610-1231
Mailing address
7409 Valley Lake Dr
Raleigh, NC 27612-6937
Phone (919) 848-3697
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 |
|---|---|---|---|
| 553 | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196208000000",
"number": "1740462092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7409 VALLEY LAKE DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276126937",
"telephone_number": "919-848-3697",
"fax_number": "919-350-7130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 NEW BERN AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101231",
"telephone_number": "919-350-7989",
"fax_number": "919-350-7130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROY",
"first_name": "WADSWORTH",
"middle_name": "DUANE",
"name_prefix": "Mr.",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-28",
"last_updated": "2007-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "553",
"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 Nov 28, 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.