NPIMap

Organization Active NPI

Phoenix Physical Therapy and Sports Performance -Lake Norman

  • Orthopedic Physical Therapist
  • Terrell, NC
National Provider Identifier
1013451301
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
P14807 Issued in NC
Legal business name
PHOENIX PHYSICAL THERAPY AND SPORTS PERFORMANCE -LAKE NORMAN
Practice address
7825 NC Highway 150 E Ste 6
Terrell, NC 28682-8703
Phone
(704) 483-0777
Fax
(704) 483-1883
NPI assigned
Dec 6, 2016
Last updated
Dec 6, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOENIX PHYSICAL THERAPY AND SPORTS PERFORMANCE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Authorized official

Name
Joshua D Vaughan, DPTNPI 1033537600
Title
Managing Member
Phone
(704) 483-0777

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X P14807 NC Primary

Addresses

Primary practice location

7825 NC Highway 150 E Ste 6
Terrell, NC 28682-8703

Mailing address

290 N Highway 16
Denver, NC 28037-8011
Phone (704) 483-0777

National Provider Directory

National Provider Directory
Part of
Phoenix Physical Therapy Sports Performance

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1013451301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 N HIGHWAY 16",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280378011",
            "telephone_number": "704-483-0777",
            "fax_number": "704-483-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7825 NC HIGHWAY 150 E STE 6",
            "city": "TERRELL",
            "state": "NC",
            "postal_code": "286828703",
            "telephone_number": "704-483-0777",
            "fax_number": "704-483-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PHYSICAL THERAPY AND SPORTS PERFORMANCE -LAKE NORMAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC",
        "enumeration_date": "2016-12-06",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "704-483-0777",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "P14807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terrell, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.