Active NPI
Dewight Carruth
- Kinesiotherapist
- Valdosta, GA
National Provider Identifier
1801415351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Kinesiotherapist
- Practice address
- 1624 Lexington Cir
Valdosta, GA 31602-5700 - Phone
- (706) 536-7664
- NPI assigned
- Apr 14, 2020
- 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 |
|---|---|---|---|---|
| Kinesiotherapist | 226300000X | Primary |
Addresses
Primary practice location
1624 Lexington Cir
Valdosta, GA 31602-5700
Mailing address
1624 Lexington Cir
Valdosta, GA 31602-5700
Phone (706) 536-7664
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | acuityschedule.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586822400000",
"number": "1801415351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1624 LEXINGTON CIR",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316025700",
"telephone_number": "706-536-7664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1624 LEXINGTON CIR",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316025700",
"telephone_number": "706-536-7664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRUTH",
"first_name": "DEWIGHT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-14",
"last_updated": "2020-04-14",
"certification_date": "2020-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "226300000X",
"taxonomy_group": "",
"desc": "Kinesiotherapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "acuityschedule.com",
"affiliation": "N",
"address_1": "1624 Lexington Cir",
"city": "Valdosta",
"state": "GA",
"country_code": "US",
"postal_code": "316025700",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Valdosta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.