Active NPI
Joanna Faught
- Physical Therapy Assistant
- Mattoon, IL
National Provider Identifier
1922380260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160005726
- Practice address
- 24 Carrollton Est
Mattoon, IL 61938-9598 - Phone
- (217) 259-7353
- NPI assigned
- Sep 13, 2011
- 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 Therapy Assistant | 225200000X | 160005726 | IL | Primary |
Addresses
Primary practice location
24 Carrollton Est
Mattoon, IL 61938-9598
Mailing address
11315 Corporate Blvd
Suite 100
Orlando, FL 32817-8344
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 |
|---|---|---|---|
| 160005726 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1922380260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11315 CORPORATE BLVD",
"address_2": "SUITE 100",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328178344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 CARROLLTON EST",
"city": "MATTOON",
"state": "IL",
"postal_code": "619389598",
"telephone_number": "217-259-7353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAUGHT",
"first_name": "JOANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160005726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mattoon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.