Emma Grace Stanbery

Individual provider Active NPI Physical Therapist · Pilot Mountain, NC

NPI 1992432900 · NPPES record last updated Aug 1, 2022

Key facts

NPI
1992432900
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
A7929 (NC)
Practice address
106 N Key St
Pilot Mountain, NC 27041-7587
Phone
(336) 444-4006
NPI assigned
Aug 1, 2022
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A7929NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Propel Pediatric Therapy Physical Therapist Past
since Aug 7, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X A7929 NC Yes

Addresses

Primary practice location

106 N Key St
Pilot Mountain, NC 27041-7587

Mailing address

1130D Snow Bridge LN
Kernersville, NC 27284-8411
Phone (336) 904-0467

Other providers in Pilot Mountain, NC

All providers in Pilot Mountain, NC · Physical Therapist in North Carolina

Sources for this page

Verify at the official NPI Registry.