Active NPI
Justin Robert Kozlowski, PT, DPT
- Physical Therapist
- Lillington, NC
National Provider Identifier
1952857443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P17796
- Practice address
- 2 The Square at Lillington
Lillington, NC 27546-8030 - Phone
- (910) 893-2850
- Fax
- (910) 984-1515
- NPI assigned
- Aug 25, 2016
- Last updated
- Sep 5, 2019
- Sex
- Male
- 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 | P17796 | NC | Primary |
Addresses
Primary practice location
2 The Square at Lillington
Lillington, NC 27546-8030
Mailing address
154 Bow St Apt B
Fayetteville, NC 28301-2300
Phone (716) 785-8282
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 |
|---|---|---|---|
| P17796 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567641600000",
"number": "1952857443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 BOW ST APT B",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283012300",
"telephone_number": "716-785-8282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 THE SQUARE AT LILLINGTON",
"city": "LILLINGTON",
"state": "NC",
"postal_code": "275468030",
"telephone_number": "910-893-2850",
"fax_number": "910-984-1515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZLOWSKI",
"first_name": "JUSTIN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-25",
"last_updated": "2019-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P17796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lillington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.