Individual provider Active NPI

Thomas Charles Fish, PT

  • Physical Therapist
  • Kernersville, NC
National Provider Identifier
1124078464
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8652 Issued in NC
Practice address
1027 E Mountain St # 101
Kernersville, NC 27284-7902
Phone
(336) 996-4980
Fax
(336) 996-3521
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8652 NC Primary

Addresses

Primary practice location

1027 E Mountain St # 101
Kernersville, NC 27284-7902

Mailing address

1027 E Mountain St # 101
Kernersville, NC 27284-7902
Phone (336) 996-4980

Other identifiers 1

IdentifierTypeStateIssuer
7211542MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111109000006 NC Practitioner - Physical Therapist in Private Practice 8426022377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1027 E Mountain St
Suite 101
Kernersville, NC 27284-7902
Phone (336) 996-4980

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100Reported as group
Quality
80
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8652NCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kernersville Rehab Specialists LLC Physical Therapist CurrentSince Jun 9, 2003 Accepting new patients

Locations

1027 E Mountain St
Ste 101
Kernersville, NC 27284
Phone (336) 996-4980

1031 E Mountain St
Ste 101
Kernersville, NC 27284
Phone (336) 996-4980

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1124078464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E MOUNTAIN ST # 101",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847902",
            "telephone_number": "336-996-4980",
            "fax_number": "336-996-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 E MOUNTAIN ST # 101",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847902",
            "telephone_number": "336-996-4980",
            "fax_number": "336-996-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "THOMAS",
        "middle_name": "CHARLES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211542",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.