Jibran Qayumi, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P17194 Issued in NC

Practice address

204 Matthews Drive
Holly Springs, NC 27540

Phone

(919) 578-4200

Fax

(919) 578-9922

NPI assigned

May 23, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mediq Physical TherapyGroup PAC ID 2567841638, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mediq Physical Therapy

  • Physical Therapist
  • Holly Springs, NC
  • NPI 1801561741
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754784000000",
    "number": "1043748957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MATTHEWS DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275404302",
            "telephone_number": "919-578-4200",
            "fax_number": "919-578-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MATTHEWS DRIVE",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "27540",
            "telephone_number": "919-578-4200",
            "fax_number": "919-578-9922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5716 W Gate City Blvd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274077039",
            "country_code": "US",
            "telephone_number": "336-600-9930",
            "fax_number": "336-600-9960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QAYUMI",
        "first_name": "JIBRAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2025-08-10",
        "certification_date": "2025-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P17194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Puleio, PHARM.D.
• Faith Purdie
• Stephanie Ann Putkowski Augustus, OTR/L
• Jennifer A Putt, LCSW
• Jennifer Mary Putzi, LCMHC-A
• Ashley Nicole Raab
• Ashley Taylor Railsback, O.T.
• Raleigh NC Endoscopy ASC LLC
• Lydia Kymberlie Sparks Ramos, PA-C
• Alexis Rangel

• Physical Therapist in Holly Springs, NC
• Providers in Holly Springs, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.