Organization Active NPI

Integrated Pediatric Therapies

  • Physical Medicine & Rehabilitation Physician
  • Whiteville, NC
National Provider Identifier
1013426980
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
INTEGRATED PEDIATRIC THERAPIES
Practice address
138 Memory PLZ
Whiteville, NC 28472-2640
Phone
(910) 393-9749
Fax
(910) 250-1244
NPI assigned
Sep 23, 2017
Organization subpart
Yes
Parent organization
INTEGRATED PEDIATRIC THERAPIES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Mr. Jeffrey W Wickline, OTRNPI 1760899686
Title
Owner and Therapist
Phone
(203) 217-9366

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Home Health Agency 251E00000X 9721 NC
Home Health Agency 251E00000X 1758 CT

Addresses

Primary practice location

138 Memory PLZ
Whiteville, NC 28472-2640

Mailing address

3260 Oceanic Bay Dr
Southport, NC 28461-6401
Phone (203) 217-9366

Other practice location 1

3260 Oceanic Bay Dr
Southport, NC 28461-6401
Phone (203) 217-9366

Other names 1

  • Kids at play Doing business as

National Provider Directory

National Provider Directory
Part of
Integrated Pediatric Therapies

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1506124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1013426980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 OCEANIC BAY DR",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284616401",
            "telephone_number": "203-217-9366",
            "fax_number": "910-393-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 MEMORY PLZ",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722640",
            "telephone_number": "910-393-9749",
            "fax_number": "910-250-1244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3260 Oceanic Bay Dr",
            "address_purpose": "LOCATION",
            "city": "Southport",
            "state": "NC",
            "postal_code": "284616401",
            "country_code": "US",
            "telephone_number": "203-217-9366",
            "fax_number": "910-250-1244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED PEDIATRIC THERAPIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED PEDIATRIC THERAPIES LLC",
        "enumeration_date": "2017-09-23",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "WICKLINE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER AND THERAPIST",
        "authorized_official_telephone_number": "203-217-9366",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "9721",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CT",
            "license": "1758",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids at play",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.