Individual provider Active NPI

Jennifer August Hyatt

  • Physical Therapist
  • Knightdale, NC
National Provider Identifier
1922573997
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18166 Issued in NC
Practice address
502 McKnight Dr Ste 103
Knightdale, NC 27545-7050
Phone
(919) 217-8885
Fax
(919) 217-8820
NPI assigned
Oct 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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 18166 NC Primary

Addresses

Primary practice location

502 McKnight Dr Ste 103
Knightdale, NC 27545-7050

Mailing address

16 Maybrook Rd Ste C
Campbell Hall, NY 10916-2741
Phone (845) 636-4344

Other names 1

  • Jennifer August Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181126000443 NC Practitioner - Physical Therapist in Private Practice 2769736065 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18166NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports & More Physical Therapy, Inc. Physical Therapist CurrentSince Jan 1, 2021 Accepting new patients
North Carolina Luna Care Physical Therapy LLC Physical Therapist CurrentSince Nov 27, 2023 Accepting new patients

Locations

8838 US Highway 70 W
Ste 300
Clayton, NC 27520
Phone (919) 550-7722

502 McKnight Dr
Ste 103
Knightdale, NC 27545
Phone (919) 217-8885

8300 Health Park
Ste 127
Raleigh, NC 27615
Phone (919) 845-6160

16 Maybrook Rd
Ste D
Campbell Hall, NY 10916

Organizations & group practices 2

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": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1922573997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MAYBROOK RD STE C",
            "city": "CAMPBELL HALL",
            "state": "NY",
            "postal_code": "109162741",
            "telephone_number": "845-636-4344",
            "fax_number": "845-636-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 MCKNIGHT DR STE 103",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457050",
            "telephone_number": "919-217-8885",
            "fax_number": "919-217-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYATT",
        "first_name": "JENNIFER",
        "middle_name": "AUGUST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "18166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "AUGUST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.