Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Gerald Dwayne Stakely Jr., PTA

Individual provider Physical Therapy Assistant · NPI 1952895617

Mr. Gerald Dwayne Stakely Jr., PTA is a Physical Therapy Assistant in Mocksville, North Carolina. Licensed in North Carolina. Registered with an NPI since 2018.

Licensed in
NC
In the registry since
2018
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

162 Deacon Way
Mocksville, NC 27028-5183
Phone: (336) 480-8368
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 6516 (NC)

Record details

NPI number1952895617
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedJune 17, 2018
Last updated in NPPESJune 17, 2018

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