Active NPI
Garrett Fetty
- Physical Therapist
- Fairmont, WV
National Provider Identifier
1992246102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 003487
- Practice address
- 14 E Grafton Rd
Fairmont, WV 26554-0067 - Phone
- (304) 363-0050
- NPI assigned
- Mar 20, 2017
- 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 | PT 003487 | WV | Primary |
Addresses
Primary practice location
14 E Grafton Rd
Fairmont, WV 26554-0067
Mailing address
14 E Grafton Rd
Fairmont, WV 26554-0067
Phone (304) 363-0050
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 |
|---|---|---|---|
| PT 003487 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489968000000",
"number": "1992246102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 E GRAFTON RD",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265540067",
"telephone_number": "304-363-0050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 E GRAFTON RD",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265540067",
"telephone_number": "304-363-0050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETTY",
"first_name": "GARRETT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-20",
"last_updated": "2017-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "PT 003487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairmont, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.