NATHAN ADAM FOX PT, DPT
NPI 1427578756
Physical Therapist in Marshall, NC

NPI Status: Active since June 27, 2017

Contact Information

415 ELDERBERRY LN
MARSHALL, NC
ZIP 28753
Phone: (828) 252-1790

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  • Individual
  • Male
  • Years of Experience 9
  • Physical Therapist
  • Accepts Medicare Approved Payment

About NATHAN FOX

This page provides the complete NPI Profile along with additional information for Nathan Fox, a provider established in Marshall, North Carolina with a medical specialization in Physical Therapist and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1427578756 assigned on June 2017. The practitioner's primary taxonomy code is 225100000X with license number 17118 (NC). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI
1427578756
Provider Name
NATHAN ADAM FOX PT, DPT
Gender
Male
Entity Type
Individual
Location Address
415 ELDERBERRY LN MARSHALL, NC 28753
Location Phone
(828) 252-1790
Mailing Address
1320 MORGAN WAY APT 303 WINSTON SALEM, NC 27127
Mailing Phone
(865) 385-9061
Medical School Name
OTHER
Graduation Year
2017
Is Sole Proprietor?
Yes
Enumeration Date
06-27-2017
Last Update Date
06-27-2017
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Therapist

Taxonomy Code
225100000X
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.
17118
License State
NC
Taxonomy Description
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Medicare Participation & PECOS Enrollment Status

Nathan Fox is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • PECOS PAC ID: 5193186641

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20230731002155

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.97 for a new patient copayment and $16.93 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 28753 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $83.9
  • Minimum New Patient Price $54.12
  • Maximum New Patient Price $165.09
  • Average New Patient Copayment $20.97
  • Minimum New Patient Copayment $13.53
  • Maximum New Patient Copayment $41.27

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.72
  • Minimum Established Patient Price $17.21
  • Maximum Established Patient Price $134.61
  • Average Established Patient Copayment $16.93
  • Minimum Established Patient Copayment $4.3
  • Maximum Established Patient Copayment $33.65

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1427578756
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
244710716710
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 4 + 7 + 1 + 0 + 7 + 1 + 6 + 7 + 1 + 0 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1427578756 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 11 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1578687232WILKINSON CARE CENTER, INC.
Organization
Assisted Living Facility415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 252-1790
1265556294WILKINSON CARE CENTER, INC.
Organization
Skilled Nursing Facility415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 252-1790
1295147296 MARK RESNGIT
Individual
Physical Therapist415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 252-1790
1922475409MR. TYLER POPE
Individual
Speech-Language Pathologist415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 252-1790
1033582051 KELLY CLEVELAND OTR/L
Individual
Occupational Therapist415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 649-9345
1760857049 ERICA CAMPBELL CF-SLP
Individual
Speech-Language Pathologist415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 252-1790
1861084394 VIRGINIA WEAVER SLP
Individual
Speech-Language Pathologist415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 252-1790
1841952496 KRISTEN LEIGH RICH
Individual
Speech-Language Pathologist415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 252-1790
1164112694 GRETCHEN YVONNE SHIMER OTD, OTR/L
Individual
Occupational Therapist415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 649-9345
1114795010 DANIEL THOMAS CAMACHO
Individual
Physical Therapist415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 252-1790
1831926930 BAILEY SIERRA MATNEY OTR/L
Individual
Occupational Therapist415 ELDERBERRY LN
MARSHALL, NC 28753
(828) 252-1790

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1427578756, enumerated in the NPI registry as an "individual" on June 27, 2017

The provider is located at 415 Elderberry Ln Marshall, Nc 28753 and the phone number is (828) 252-1790

The provider's speciality is Physical Therapist with taxonomy code 225100000X

The provider has more than 9 years of experience.

Medicare beneficiaries should expect a typical cost of $83.9 with an average copayment of $20.97 for new patient appointments. Established patients should expect a typical charge of $67.72 and an average copayment of 16.93. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on June 27, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.