Organization Active NPI

Cleveland Physical Therapy Assoc II

  • Physical Therapy Assistant
  • Shelby, NC
National Provider Identifier
1114908290
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
9863 Issued in NC
Legal business name
CLEVELAND PHYSICAL THERAPY ASSOC II
Practice address
335B W College Ave
Shelby, NC 28152-8111
Phone
(704) 434-8175
Fax
(704) 434-8176
NPI assigned
Nov 7, 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
Mr. James E Crowell
Title
Director of Administration
Phone
(704) 471-0001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 9863 NC Primary

Addresses

Primary practice location

335B W College Ave
Shelby, NC 28152-8111

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
7211706MedicaidNC

National Provider Directory

National Provider Directory

Locations

335B W College Ave
Shelby, NC 28152
Phone (704) 434-8175

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114908290",
    "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": "335B W COLLEGE AVE",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281528111",
            "telephone_number": "704-434-8175",
            "fax_number": "704-434-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND PHYSICAL THERAPY ASSOC II",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CROWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "704-471-0001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "9863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211706",
            "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.