Active NPI
Jessica Martin King, P.T.
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1770868887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13356
- Practice address
- 11550 Common Oaks Dr
Suite 100
Raleigh, NC 27614-7298 - Phone
- (919) 453-5740
- Fax
- (919) 453-5741
- NPI assigned
- Oct 20, 2011
- Sex
- Female
- 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 | 13356 | NC | Primary |
Addresses
Primary practice location
11550 Common Oaks Dr
Suite 100
Raleigh, NC 27614-7298
Mailing address
120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13356 | Other | NC | NC PT LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13356 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319068800000",
"number": "1770868887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 WILLIAM PENN PLZ",
"city": "DURHAM",
"state": "NC",
"postal_code": "277042150",
"telephone_number": "919-220-5255",
"fax_number": "919-313-1276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11550 COMMON OAKS DR",
"address_2": "SUITE 100",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276147298",
"telephone_number": "919-453-5740",
"fax_number": "919-453-5741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JESSICA",
"middle_name": "MARTIN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-20",
"last_updated": "2011-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "13356",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC PT LICENSE NUMBER",
"identifier": "13356",
"state": "NC"
}
],
"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 Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.