Individual provider Active NPI

Jordan Rosenberger

  • Physical Therapist
  • Nags Head, NC
National Provider Identifier
1023407129
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P19848 Issued in NC
Practice address
430 W Health Center Dr
Nags Head, NC 27959-8943
Phone
(440) 669-6040
NPI assigned
Jan 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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 P19848 NC Primary

Addresses

Primary practice location

430 W Health Center Dr
Nags Head, NC 27959-8943

Mailing address

142 Roanoke Dr
Kill Devil Hills, NC 27948-9196
Phone (440) 669-6040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618000055 NC Practitioner - Physical Therapist in Private Practice 3072878222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Rehabilitation IncGroup PAC ID 9537071535, 17 clinicians

Practice addresses (Care Compare)

5585 N Croatan Hwy
Kitty Hawk, NC 27949-3996
Phone (252) 261-1556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P19848NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Rehabilitation Inc Physical Therapist CurrentSince Jun 1, 2025 Accepting new patients
Coastal Rehabilitation Inc Physical Therapist CurrentSince Jun 1, 2025 Accepting new patients
Broad River Rehabilitation Physical Therapist CurrentSince Feb 25, 2026 Accepting new patients
Coastal Rehabilitation Inc Physical Therapist Past Accepting new patients

Locations

101 Medical Dr
Elizabeth Cty, NC 27909
Phone (252) 338-2114

803 Bermuda Bay Blvd
Kill Devil Hills, NC 27948
Phone (252) 449-4455

5585 N Croatan Hwy
Kitty Hawk, NC 27949
Phone (252) 261-1556

503 Cypress Ln
#A
Manteo, NC 27954
Phone (252) 338-2114

Organizations & group practices 4

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": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1023407129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 ROANOKE DR",
            "city": "KILL DEVIL HILLS",
            "state": "NC",
            "postal_code": "279489196",
            "telephone_number": "440-669-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W HEALTH CENTER DR",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598943",
            "telephone_number": "440-669-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERGER",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.