Active NPI
Gabriele Renzi, PT
- Physical Therapist
- Eden, NC
National Provider Identifier
1861707226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12793
- Practice address
- 640 S Van Buren Rd
Eden, NC 27288-5320 - Phone
- (336) 623-0975
- Fax
- (336) 623-0977
- NPI assigned
- Aug 10, 2010
- Last updated
- Nov 21, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6264 | SC | |
| Physical Therapist | 225100000X | 12793 | NC | Primary |
Addresses
Primary practice location
640 S Van Buren Rd
Eden, NC 27288-5320
Mailing address
PO Box 4576
Asheboro, NC 27204-4576
Phone (336) 629-6397
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 |
|---|---|---|---|
| 12793 | NC | MD | Physical Therapist |
| 6264 | SC | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384992000000",
"number": "1861707226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4576",
"city": "ASHEBORO",
"state": "NC",
"postal_code": "272044576",
"telephone_number": "336-629-6397",
"fax_number": "336-629-6939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 S VAN BUREN RD",
"city": "EDEN",
"state": "NC",
"postal_code": "272885320",
"telephone_number": "336-623-0975",
"fax_number": "336-623-0977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENZI",
"first_name": "GABRIELE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-10",
"last_updated": "2013-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "6264",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "12793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.