Active NPI
Irvin Dubose
- Physical Therapist
- Southern Pines, NC
National Provider Identifier
1801092317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9513
- Practice address
- 100 Gossman Rd
Southern Pines, NC 28387-2224 - Phone
- (910) 295-2211
- NPI assigned
- Jun 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 9513 | NC | Primary |
Addresses
Primary practice location
100 Gossman Rd
Southern Pines, NC 28387-2224
Mailing address
470 Longleaf Dr E
Pinehurst, NC 28374-8016
Phone (910) 295-6684
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 |
|---|---|---|---|
| 9513 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801092317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "470 LONGLEAF DR E",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283748016",
"telephone_number": "910-295-6684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 GOSSMAN RD",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283872224",
"telephone_number": "910-295-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOSE",
"first_name": "IRVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "9513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southern Pines, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.