Individual provider Active NPI

Alena Serdarevic, PTA

  • Physical Therapy Assistant
  • Charlotte, NC
National Provider Identifier
1104065671
Registry record updated Feb 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3530 Issued in NC
Practice address
138 Wyanoke Ave
Charlotte, NC 28205-6141
Phone
(704) 499-8969
NPI assigned
Feb 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3530 NC Primary

Addresses

Primary practice location

138 Wyanoke Ave
Charlotte, NC 28205-6141

Mailing address

138 Wyanoke Ave
Charlotte, NC 28205-6141
Phone (704) 499-8969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233878400000",
    "number": "1104065671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 WYANOKE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056141",
            "telephone_number": "704-499-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 WYANOKE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056141",
            "telephone_number": "704-499-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERDAREVIC",
        "first_name": "ALENA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "3530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 6, 2009; 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.