Individual provider Active NPI

Vishwa Bhargav Bhalodia, PHYSICAL THERAPIST

  • Physical Therapist
  • Holly Springs, NC
National Provider Identifier
1013439249
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P17223 Issued in NC
Practice address
500 Village Walk Dr
Holly Springs, NC 27540-4440
Phone
(919) 258-2200
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P17223 NC Primary

Addresses

Primary practice location

500 Village Walk Dr
Holly Springs, NC 27540-4440

Mailing address

PO Box 412313
Boston, MA 02241-2313
Phone (914) 294-4050

Other practice location 1

2119 Crigan Bluff Dr
Cary, NC 27513-8352
Phone (919) 592-2718

Other practice location 2

2119 Crigan Bluff Dr
Cary, NC 27513-8352
Phone (919) 592-2718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210601000510 NC Practitioner - Physical Therapist in Private Practice 3274932975 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

500 Village Walk Dr
Holly Springs, NC 27540-4440
Phone (919) 258-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P17223NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Clinic of NC PC Physical Therapist CurrentSince Nov 4, 2024 Accepting new patients
Ivyrehab North Carolina LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Integrated Therapy LLC Physical Therapist CurrentSince Jun 1, 2021 Accepting new patients
North Carolina Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 25, 2021 Accepting new patients
Ivyrehab North Carolina LLC CurrentSince Sep 30, 2024 Accepting new patients

Locations

2221 Peachtree Rd NE
Ste D336
Atlanta, GA 30309

1700 Regency Pkwy
Cary, NC 27518
Phone (404) 351-5309

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

500 Village Walk Dr
Holly Springs, NC 27540
Phone (919) 258-2200

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1013439249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412313",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412313",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VILLAGE WALK DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275404440",
            "telephone_number": "919-258-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2119 Crigan Bluff Dr",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275138352",
            "country_code": "US",
            "telephone_number": "919-592-2718",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2119 Crigan Bluff Dr",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275138352",
            "country_code": "US",
            "telephone_number": "919-592-2718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHALODIA",
        "first_name": "VISHWA",
        "middle_name": "BHARGAV",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P17223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.