Optimum Rehab & Sports Training, LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

P6231 Issued in NC

Legal business name

OPTIMUM REHAB & SPORTS TRAINING, LLC

Practice address

6405 Westgate Rd
Suite 105
Raleigh, NC 27617-4757

Phone

(919) 508-6835

NPI assigned

Aug 29, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Dufault, PT

Title

Owner/Physical Therapist

Phone

(919) 667-4873

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1003165663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 WESTGATE RD",
            "address_2": "SUITE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276174757",
            "telephone_number": "919-508-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 WESTGATE RD",
            "address_2": "SUITE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276174757",
            "telephone_number": "919-508-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM REHAB & SPORTS TRAINING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "DUFAULT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "919-667-4873",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "P6231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optima Solutions Agency
• Optimal Behavioral Health
• Optimize Physical Therapy LLC
• Optimum Health Chiropractic
• Optimum Mobile Rehabilitation L.L.C.
• Optimusortho Bundle Management, LLC
• Optometric Eye Tech PA
• Optonesis LLC
• Optum Behavioral Care of North Carolina, PC
• Optum Infusion Services 553, LLC

• Orthopedic Physical Therapist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Orthopedic Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.