Active NPI
Julieann Mottern, PT, DPT
- Physical Therapist
- Fort Gordon, GA
National Provider Identifier
1932511854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004204
- Practice address
- 300 East Hospital Road, Room 10B-01
Dwight D. Eisenhower Army Medical Center
Fort Gordon, GA 30905-5650 - Phone
- (706) 787-5811
- NPI assigned
- May 27, 2014
- 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 Therapist | 225100000X | 004204 | KY | Primary |
Addresses
Primary practice location
300 East Hospital Road, Room 10B-01
Dwight D. Eisenhower Army Medical Center
Fort Gordon, GA 30905-5650
Mailing address
300 East Hospital Road, Room 10B-01
Dwight D. Eisenhower Army Medical Center
Fort Gordon, GA 30905-5650
Phone (706) 787-5811
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004204 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401148800000",
"number": "1932511854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 EAST HOSPITAL ROAD, ROOM 10B-01",
"address_2": "DWIGHT D. EISENHOWER ARMY MEDICAL CENTER",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055650",
"telephone_number": "706-787-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 EAST HOSPITAL ROAD, ROOM 10B-01",
"address_2": "DWIGHT D. EISENHOWER ARMY MEDICAL CENTER",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055650",
"telephone_number": "706-787-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOTTERN",
"first_name": "JULIEANN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-27",
"last_updated": "2014-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "004204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.