Individual provider Active NPI

Jamie Randall Eudy, PTA

  • Physical Therapy Assistant
  • Albemarle, NC
National Provider Identifier
1891039277
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2466 Issued in NC
Practice address
24724 S Business 52
Albemarle, NC 28001-8179
Phone
(704) 986-0862
NPI assigned
Nov 26, 2012
Last updated
Nov 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2466 NC Primary

Addresses

Primary practice location

24724 S Business 52
Albemarle, NC 28001-8179

Mailing address

24724 S Business 52
Albemarle, NC 28001-8179
Phone (704) 986-0862

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

LicenseStateTypeSpecialty
2466NCMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1891039277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24724 S BUSINESS 52",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280018179",
            "telephone_number": "704-986-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24724 S BUSINESS 52",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280018179",
            "telephone_number": "704-986-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUDY",
        "first_name": "JAMIE",
        "middle_name": "RANDALL",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "2466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.