{"npi":"1194802421","type":"NPI-1","status":"active","name":{"display":"Charles Roy Pt","other":[],"first":"CHARLES","last":"ROY","middle":"K.","credential":"PT"},"specialty":{"primary_taxonomy":"225100000X","primary_taxonomy_description":"Physical Therapist","slug":"physical-therapist","schema_org_specialty":null,"all":[{"code":"174400000X","description":"Specialist","primary":false,"state":"WV","license":"000684"},{"code":"174400000X","description":"Specialist","primary":false,"state":"VA","license":"2305003386"},{"code":"225100000X","description":"Physical Therapist","primary":false,"state":"WV","license":"0156640000"},{"code":"225100000X","description":"Physical Therapist","primary":true,"state":"VA","license":"2305003386"}]},"addresses":[{"purpose":"LOCATION","street_1":"130 MEDICAL CIR","city":"WINCHESTER","state":"VA","postal_code":"226013322","country_code":"US","phone":"5406677076","fax":"5406675773"},{"purpose":"MAILING","street_1":"PO BOX 2217","city":"WINCHESTER","state":"VA","postal_code":"226041417","country_code":"US","phone":"5406678975","fax":"5405048205"}],"license":{"state":"VA","number":"2305003386"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"0156640000","state":"WV","issuer":null},{"type_code":"05","label":"Medicaid","value":"3810004945","state":"VA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20100802000228","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"WV","pac_id":"2769515428"},{"enrlmt_id":"I20101019001394","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"VA","pac_id":"2769515428"}]},"enumeration_date":"2006-11-01","last_updated":"2023-11-29","_meta":{"source":"NPPES","snapshot_date":"2023-11-29","doc_url":"https://findmynpi.com/api"}}