CAROLINA SPORT & SPINE PHYSICAL THERAPY, INC. (NPI# 1023533205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023533205 |
| Entity Type | Organization |
| Organization Name | CAROLINA SPORT & SPINE PHYSICAL THERAPY, INC. |
| Practice Address |
555 Fayetteville St Ste 201 Raleigh NC 27601 |
| Mailing Address |
Po Box 54 Zebulon NC 27597-0054 |
| Practice Telephone | 9194041448 |
| Practice Fax Number | 8005058690 |
| Mailing Fax Number | 8005058690 |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2020-04-16 |
| Authorized Official Name | DERRICK BRIDDELL (PRESIDENT) |
| Authorized Official Telephone | 2523671118 |
| Authorized Official Credential | DSCPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3108 Ginger Lake Ct, Zebulon, NC 275975737 | 2523671118 |
| Street Address |
555 FAYETTEVILLE ST STE 201 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558926451 | Carolina Rehabworks, Inc. | Occupational Therapist | 555 Fayetteville St Ste 201, Raleigh, NC 27601-3034 | 2019-05-06 |
| 1205352697 | Divine Legends LLC | Community/Behavioral Health | 555 Fayetteville St Ste 201, Raleigh, NC 27601-3034 | 2017-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123061 | Sarah C Blankenship | Behavior Technician | 421 Fayette Street Suite 1100, Raleigh, NC 27601 | 2020-10-29 |
| 1700428513 | Amanda Sue Abner | Behavior Technician | 421 Fayetteville St. Suite 1100, Raleigh, NC 27601 | 2019-10-14 |
| 1720632680 | Courtney R Dickerson | Behavior Technician | 421 Fayettville St. Suite 1100, Raleigh, NC 27601 | 2019-07-30 |
| 1902346067 | Nc Community Care Services Inc | Day Training, Developmentally Disabled Services | 555 Fayetteville Street, Ste. 201, Raleigh, NC 27601 | 2017-03-08 |
| 1649712399 | Sleep Health and Wellness Center, Pllc | Sleep Specialist, PhD | 555 S Wilmington St, Suite 201, Raleigh, NC 27601 | 2016-11-12 |
| 1093267817 | Kristen Ashley Eubanks | Behavior Technician | 421 Fayetteville Street Suite 1100, Raleigh, NC 27601 | 2016-10-27 |
| 1205281631 | Kayla Christian Hart | Developmental Therapist | 421 Fayetteville Street, Suite 1100, Raleigh, NC 27601 | 2016-05-04 |
| 1457759003 | Vanessa Lech | Social Worker | 555 Fayetteville St, Suite 201, Raleigh, NC 27601 | 2014-12-15 |
| 1649513177 | Manual Medicine Physical Therapy | Clinic/Center | 300 W. Hargett St., Apt. 307, Raleigh, NC 27601 | 2013-04-03 |
| 1457581514 | Patricia Jean Bilitzke | Counselor | 33 W Davie St., Raleigh, NC 27601 | 2009-07-22 |
| Find all providers in zip 27601 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958930 | Rise Physical Therapy LLC | Clinic/Center | 3710 Exchange Glenwood Pl Apt 346, Raleigh, NC 27612-4853 | 2020-06-29 |
| 1447733878 | Swarajchand Corp | Clinic/Center | 8320 Litchford Rd Ste 140, Raleigh, NC 27615-3860 | 2018-09-12 |
| 1073069035 | Performax Physical Therapy and Sports Rehabilitation, LLC | Clinic/Center | 8700 Walkelin Ct, Raleigh, NC 27615-4147 | 2016-08-30 |
| 1659731214 | Agilitas Usa, Inc | Clinic/Center | 815 Oberlin Rd # 302, Raleigh, NC 27605-1300 | 2016-02-25 |
| 1336508688 | Optimum Mobile Rehabilitation L.L.C. | Clinic/Center | 150 Saint Mellion St, Raleigh, NC 27603-4175 | 2016-02-15 |
| 1437524600 | Agilitas Usa Inc | Clinic/Center | 11201 Galleria Ave # 105, Raleigh, NC 27614-8137 | 2015-12-14 |
| 1235528985 | Xcel Rehabilitation Services | Clinic/Center | 12528 Honeychurch St, Raleigh, NC 27614-8482 | 2015-01-19 |
| 1457768335 | Legacy Healthcare Services, Inc. | Clinic/Center | 7900 Creedmoor Rd, Raleigh, NC 27613-4382 | 2014-07-12 |
| 1649513177 | Manual Medicine Physical Therapy | Clinic/Center | 300 W. Hargett St., Apt. 307, Raleigh, NC 27601 | 2013-04-03 |
| 1912190174 | S.t.a.c.k. Physical Therapy & Corrective Exercise, Incorporated | Clinic/Center | 1640 Eva Mae Dr, Raleigh, NC 27610-4443 | 2007-08-21 |
| Find all providers in RALEIGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.