MEDICARE: EDWARD JOSEPH MCGINNISS V DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	P24125	NC

General Provider Information

NPI Number	:	1578459368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD JOSEPH MCGINNISS V DPT

Provider Business Mailing Address
First Line	:	906 MEBANE OAKS RD
Second Line	:
City	:	MEBANE
State	:	NC
Zip	:	27302-7951
Country	:	US
Telephone Number	:	919-563-1825
Fax Number	:	919-563-1833

Provider Business Practice Location Address
First Line	:	2766 NC HIGHWAY 68 S STE 105
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8385
Country	:	US
Telephone Number	:	336-889-7063
Fax Number	:	336-889-6474

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2025
Last Update Date	:	06/17/2025

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