NPIMap

Organization Active NPI

Elite Physical Therapy LLC

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1104926419
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9479 Issued in NC
Legal business name
ELITE PHYSICAL THERAPY LLC
Practice address
2630 E 7TH St
Suite 206
Charlotte, NC 28204-4318
Phone
(704) 333-1052
Fax
(704) 333-1054
NPI assigned
Sep 25, 2006
Last updated
Jun 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Authorized official

Name
Ms. Kelly Michelle Floyd, LPTNPI 1558462622
Title
President
Phone
(704) 333-1052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 9479 NC Primary

Addresses

Primary practice location

2630 E 7TH St
Suite 206
Charlotte, NC 28204-4318

Mailing address

2630 E 7TH St
Suite 206
Charlotte, NC 28204-4318
Phone (704) 333-1052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071113000094 NC Part B Supplier - Clinic/Group Practice 0840388666 Receives reassigned benefits from 7 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

14135 Ballantyne Corporate Pl
Ste 100
Charlotte, NC 28277
Phone (704) 831-4300

2630 E 7th St
Ste 206
Charlotte, NC 28204
Phone (704) 333-1052

8832 Blakeney Professional Dr
#301
Charlotte, NC 28277

8832 Blakeney Professional Dr
Ste 303
Charlotte, NC 28277
Phone (980) 237-4575

8832 Blakeney Professional Dr
Unit 303
Charlotte, NC 28277
Phone (980) 237-4575

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1104926419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST",
            "address_2": "SUITE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044318",
            "telephone_number": "704-333-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST",
            "address_2": "SUITE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044318",
            "telephone_number": "704-333-1052",
            "fax_number": "704-333-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "FLOYD",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-333-1052",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9479",
            "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 Jun 5, 2013; 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.

Verify at the official NPI Registry.