Active NPI
Jennifer Ann Caudell, MPT
- Physical Therapist
- Stanley, NC
National Provider Identifier
1972636579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10051
- Practice address
- 514 Old Mount Holly Rd
Stanley, NC 28164-2191 - Phone
- (330) 206-4706
- NPI assigned
- Mar 13, 2007
- 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 | 10051 | NC | Primary |
Addresses
Primary practice location
514 Old Mount Holly Rd
Stanley, NC 28164-2191
Mailing address
7219 Stableford LN
Stanley, NC 28164-7832
Phone (330) 206-4706
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 |
|---|---|---|---|
| 10051 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408492800000",
"number": "1972636579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7219 STABLEFORD LN",
"city": "STANLEY",
"state": "NC",
"postal_code": "281647832",
"telephone_number": "330-206-4706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "514 OLD MOUNT HOLLY RD",
"city": "STANLEY",
"state": "NC",
"postal_code": "281642191",
"telephone_number": "330-206-4706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAUDELL",
"first_name": "JENNIFER",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2014-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "10051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanley, NC
- Caromont Medical Group Inc (CaroMont Family Medicine)
- Caromont Medical Group Inc
- Caromont- South Point LLC (South Point Family Practice)
- Jennifer Case, PHD, RD, CSSD, CSCS
- David Blake Cason, D.C.
- Amy Carpenter Chapman
- Brittany Wyatt Chestnut, NP-C
- Bridget Childers
- Brianna Nicole Christiano, OTR/L
- Henry Carter Cobb, PHARM.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.