Active NPI
Orthocarolina
- Physical Therapist
- Charlotte, NC
National Provider Identifier
1063665263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 38865
- Legal business name
- ORTHOCAROLINA
- Practice address
- 15825 John J Delaney Dr
Suite 140
Charlotte, NC 28277-3146 - Phone
- (704) 323-3278
- Fax
- (704) 341-5269
- NPI assigned
- Oct 31, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Danniel B Murrey, M.D.
- Title
- Ceo
- Phone
- (704) 323-2010
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 38865 | NC | Primary |
Addresses
Primary practice location
15825 John J Delaney Dr
Suite 140
Charlotte, NC 28277-3146
Mailing address
4601 Park Rd
Suite 300
Charlotte, NC 28209-3239
Phone (704) 323-2256
Other names 1
- The Epicenter Sports Performance
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930010350 | NC | DME Supplier - Physician - General Practice | 2062316821 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Charlotte, NC |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1225411200000",
"number": "1063665263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD",
"address_2": "SUITE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093239",
"telephone_number": "704-323-2256",
"fax_number": "704-323-3911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15825 JOHN J DELANEY DR",
"address_2": "SUITE 140",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282773146",
"telephone_number": "704-323-3278",
"fax_number": "704-341-5269"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORTHOCAROLINA",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-31",
"last_updated": "2008-10-31",
"status": "A",
"authorized_official_last_name": "MURREY",
"authorized_official_first_name": "DANNIEL",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "704-323-2010",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "NC",
"license": "38865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "The Epicenter Sports Performance",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; 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.