Iron Varsity, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

IRON VARSITY, LLC

Practice address

5132 Doughtymews LN
Fuquay Varina, NC 27526-7672

Phone

(831) 524-2966

NPI assigned

Mar 25, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Colton Walker Owczarzak, PT, DPTNPI 1053058768

Title

Owner Manager

Phone

(831) 524-2966

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Colton Owczarzak, PT, DPT

  • Physical Therapist
  • Fuquay Varina, NC
  • NPI 1053058768
  NPD Authorized official

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1003666959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5132 DOUGHTYMEWS LN",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275267672",
            "telephone_number": "831-524-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5132 DOUGHTYMEWS LN",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275267672",
            "telephone_number": "831-524-2966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6109 S Nc 55 Hwy # 133",
            "address_purpose": "LOCATION",
            "city": "Fuquay Varina",
            "state": "NC",
            "postal_code": "275267920",
            "country_code": "US",
            "telephone_number": "919-518-5204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IRON VARSITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-02",
        "status": "A",
        "authorized_official_last_name": "OWCZARZAK",
        "authorized_official_first_name": "COLTON",
        "authorized_official_middle_name": "WALKER",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "831-524-2966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.