Individual provider Active NPI

Donna E. Fender, PT

  • Physical Therapist
  • Roanoke Rapids, NC
National Provider Identifier
1912199894
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8471 Issued in NC
Practice address
310 Roanoke Ave
Roanoke Rapids, NC 27870-1918
Phone
(252) 678-4065
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8471 NC Primary

Addresses

Primary practice location

310 Roanoke Ave
Roanoke Rapids, NC 27870-1918

Mailing address

310 Roanoke Ave
Roanoke Rapids, NC 27870-1918
Phone (252) 541-1941

Other identifiers 1

IdentifierTypeStateIssuer
7212307MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090203000738 NC Practitioner - Physical Therapist in Private Practice 2365506482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Brody School of Medicine at East Carolina University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dfender Physical Therapy LLC 3 clinicians

Practice addresses (Care Compare)

310 Roanoke Ave
Roanoke Rapids, NC 27870-1918
Phone (252) 678-4065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8471NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Sep 8, 2014 Accepting new patients
Dfender Physical Therapy, LLC CurrentSince Dec 9, 2022 Accepting new patients
Emergeortho PA Physical Therapist CurrentSince Sep 8, 2014 Accepting new patients
Vidant Medical Group LLC CurrentSince Nov 9, 2021 Accepting new patients
Coastal Rehabilitation Inc Physical Therapist Past Accepting new patients
Northern Carolina Orthopaedics, PLLC Past Accepting new patients
Coastal Rehabilitation Inc Physical Therapist PastSince Aug 15, 2022 Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1205 E 10th St
Roanoke Rapids, NC 27870

310 Roanoke Ave
Roanoke Rapids, NC 27870
Phone (252) 541-1941

171 NC Highway 125
Roanoke Rapids, NC 27870
Phone (252) 537-5631

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1912199894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 ROANOKE AVE",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278701918",
            "telephone_number": "252-541-1941",
            "fax_number": "866-521-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 ROANOKE AVE",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278701918",
            "telephone_number": "252-678-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDER",
        "first_name": "DONNA",
        "middle_name": "E.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212307",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.