Active NPI
Shreya M Khetan, DPT
- Physical Therapist
- Fayetteville, NC
National Provider Identifier
1841826476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P18394
- Practice address
- 4602 Cumberland Rd
Fayetteville, NC 28306-2412 - Phone
- (910) 423-5622
- Fax
- (910) 378-1755
- NPI assigned
- Mar 16, 2020
- Last updated
- Mar 16, 2020
- 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 | P18394 | NC | Primary |
Addresses
Primary practice location
4602 Cumberland Rd
Fayetteville, NC 28306-2412
Mailing address
101 Pinegate Cir Apt 5
Chapel Hill, NC 27514-2222
Phone (708) 321-0001
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 |
|---|---|---|---|
| P18394 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584316800000",
"number": "1841826476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 PINEGATE CIR APT 5",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275142222",
"telephone_number": "708-321-0001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4602 CUMBERLAND RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283062412",
"telephone_number": "910-423-5622",
"fax_number": "910-378-1755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHETAN",
"first_name": "SHREYA",
"middle_name": "M",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-16",
"last_updated": "2020-03-16",
"certification_date": "2020-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P18394",
"primary": true
}
],
"identifiers": [],
"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 Mar 16, 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.