Individual provider Active NPI

Jesse Alexander Phlegar, DPT

  • Physical Therapist
  • Fayetteville, NC
National Provider Identifier
1063103273
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP057810T Issued in NC
Practice address
1991 Fordham Dr Ste 102
Fayetteville, NC 28304-3774
Phone
(910) 484-4653
Fax
(910) 483-9256
NPI assigned
May 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP057810T NC Primary
Physical Therapist 225100000X PT031256 PA

Addresses

Primary practice location

1991 Fordham Dr Ste 102
Fayetteville, NC 28304-3774

Mailing address

1991 Fordham Dr Ste 102
Fayetteville, NC 28304-3774
Phone (910) 484-4653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230707001819 PA Practitioner - Physical Therapist in Private Practice 0840659942 Reassigns benefits to 1 organization
I20260615000276 NC Practitioner - Physical Therapist in Private Practice 0840659942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wise Physical Therapy and Sports Medicine LLCGroup PAC ID 3274787122, 12 clinicians
Cape Fear Valley Health Medical Group LLCGroup PAC ID 0648707109, 352 clinicians

Practice addresses (Care Compare)

121 Cranberry Rd
Grove City, PA 16127-4629
Phone (724) 458-9473

1991 Fordham Dr
Suite 102
Fayetteville, NC 28304-3774
Phone (910) 484-4653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP057810TNCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Physical Therapy and Sports Medicine LLC Physical Therapist CurrentSince May 30, 2023 Accepting new patients
Kuzma Physical Therapy and Sports Medicine LLC Physical Therapist PastSince Dec 29, 2019 Accepting new patients

Locations

121 Cranberry Rd
Grove City, PA 16127
Phone (724) 458-9473

110 Arrowhead Dr
Slippery Rock, PA 16057
Phone (724) 406-0506

110 Arrowhead Dr
Ste 200
Slippery Rock, PA 16057
Phone (724) 406-0506

Organizations & group practices 3

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": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1063103273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 FORDHAM DR STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043774",
            "telephone_number": "910-484-4653",
            "fax_number": "910-483-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 FORDHAM DR STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043774",
            "telephone_number": "910-484-4653",
            "fax_number": "910-483-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHLEGAR",
        "first_name": "JESSE",
        "middle_name": "ALEXANDER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-17",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "CP057810T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT031256",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; 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.