NPIMap

Organization Active NPI

Cleveland Physical Therapy Associates Inc

  • Physical Therapy Clinic/Center
  • Shelby, NC
National Provider Identifier
1093718199
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CLEVELAND PHYSICAL THERAPY ASSOCIATES INC
Practice address
1129 E Marion St
Shelby, NC 28150-4843
Phone
(704) 471-0001
Fax
(704) 471-0004
NPI assigned
May 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Donald Glenn Miller Jr., DPT, MS, PT
Title
Owner
Phone
(704) 471-0001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NC Primary

Addresses

Primary practice location

1129 E Marion St
Shelby, NC 28150-4843

Mailing address

1129 E Marion St
Shelby, NC 28150-4843
Phone (704) 471-0001

Other identifiers 8

IdentifierTypeStateIssuer
7211359MedicaidNC
7301634MedicaidNC
7211362MedicaidNC
7211364MedicaidNC
7211706MedicaidNC
7210246MedicaidNC
NC1056OtherNCSUBMITTER ID
7211360MedicaidNC

National Provider Directory

National Provider Directory

Locations

110 W King St
Ste 9
Kings Mountain, NC 28086
Phone (704) 471-0001

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093718199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 E MARION ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281504843",
            "telephone_number": "704-471-0001",
            "fax_number": "704-471-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 E MARION ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281504843",
            "telephone_number": "704-471-0001",
            "fax_number": "704-471-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND PHYSICAL THERAPY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-471-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPT, MS, PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211359",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301634",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211362",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211364",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211706",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7210246",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBMITTER ID",
            "identifier": "NC1056",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211360",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

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

Verify at the official NPI Registry.