NPIMap

Organization Active NPI

Healthy Seniors

  • Geriatric Physical Therapist
  • Wilmington, NC
National Provider Identifier
1013548072
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
Legal business name
HEALTHY SENIORS
Practice address
4829 Carolina Beach Rd Ste 100
Wilmington, NC 28412-2366
Phone
(910) 444-0020
NPI assigned
Jan 29, 2020
Last updated
Apr 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Authorized official

Name
Ross Terry, DPTNPI 1528339058
Title
Owner
Phone
(731) 845-3038

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
Geriatric Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251G0304X Primary

Addresses

Primary practice location

4829 Carolina Beach Rd Ste 100
Wilmington, NC 28412-2366

Mailing address

4829 Carolina Beach Rd Ste 100
Wilmington, NC 28412-2366
Phone (910) 444-0020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200424000790 NC Part B Supplier - Clinic/Group Practice 5193155695 Receives reassigned benefits from 11 practitioners
Practice locations: Leland, NC; Wilmington, NC

National Provider Directory

National Provider Directory

Locations

2783 Compass Pointe South Wynd NE
Unit 5
Leland, NC 28451
Phone (910) 371-8100

4829 Carolina Beach Rd
Ste 100
Wilmington, NC 28412
Phone (910) 444-0020

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1013548072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4829 CAROLINA BEACH RD STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122366",
            "telephone_number": "910-444-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4829 CAROLINA BEACH RD STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122366",
            "telephone_number": "910-444-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY SENIORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-845-3038",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.