Nathan Tometich, DPT
Individual provider Active NPI Physical Therapist · McAdenville, NC
NPI 1144086265 · NPPES record last updated Feb 26, 2024
Key facts
- NPI
- 1144086265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- P23019 (NC)
- Practice address
- 102 Main St
Suite 130
McAdenville, NC 28101-7908 - Phone
- (704) 560-6135
- NPI assigned
- Feb 26, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Custom Physical Therapy and Fitness
Practice addresses (Care Compare)
102 Main St
Suite 130
MC Adenville, NC 28101-9706
Phone (704) 560-6135
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240422001843 | NC | Practitioner - Physical Therapist in Private Practice | 0840639969 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Custom Physical Therapy and Fitness | Physical Therapist | Current |
Accepting new patients |
Locations
102 Main St
Ste 130
Mc Adenville, NC 28101
Phone (704) 560-6135
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P23019 | NC | Yes |
Addresses
Primary practice location
102 Main St
Suite 130
McAdenville, NC 28101-7908
Mailing address
102 Main St
Suite 130
McAdenville, NC 28101-9708
Phone (704) 560-6135
Other providers in McAdenville, NC
All providers in McAdenville, NC · Physical Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.