Individual provider Active NPI

Jonathan Earles

  • Physical Medicine & Rehabilitation Physician
  • Durham, NC
National Provider Identifier
1992467005
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
P19844 Issued in NC
Practice address
4309 Medical Park Dr
Durham, NC 27704-2388
Phone
(919) 385-7507
NPI assigned
Oct 6, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X P19844 NC Primary

Addresses

Primary practice location

4309 Medical Park Dr
Durham, NC 27704-2388

Mailing address

4309 Medical Park Dr
Durham, NC 27704-2388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211215000791 NC Practitioner - Physical Therapist in Private Practice 9739570342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

4309 Medical Park Dr
Durham, NC 27704-2388
Phone (919) 684-8111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Oct 25, 2021 Accepting new patients
Duke University Health System, Inc. Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Duke University Health System, Inc. Past Accepting new patients

Locations

4220 N Roxboro St
Durham, NC 27704
Phone (919) 471-1518

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3116 N Duke St
Durham, NC 27704
Phone (919) 620-5333

4309 Medical Park Dr
Durham, NC 27704
Phone (919) 471-4484

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1992467005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 MEDICAL PARK DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 MEDICAL PARK DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042388",
            "telephone_number": "919-385-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLES",
        "first_name": "JONATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "P19844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.