Active NPI
Michael Fitzgerald
- Physical Therapist
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 2001 S 17TH St
Ste 101
Wilmington, NC 28401-6628 - Phone
- (970) 763-8184
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
2001 S 17TH St
Ste 101
Wilmington, NC 28401-6628
Mailing address
4614 Whiteweld Ter
Wilmington, NC 28412-5205
Phone (910) 313-0730
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8519 | Other | NC | LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8519 | NC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proactive Therapy of North Carolina Inc | Current | Accepting new patients | |
| Proactive Therapy of North Carolina Inc | Current | Accepting new patients | |
| Proactive Therapy of North Carolina Inc | Current | Accepting new patients | |
| Select Physical Therapy Holdings Inc | Current | Accepting new patients | |
| Select Physical Therapy Holdings Inc | Current | Accepting new patients |
Locations
10020 Edison Square Dr NW
Ste C105
Concord, NC 28027
Phone (704) 948-5351
2358 US Highway 70
Ste Ab
Swannanoa, NC 28778
Phone (828) 686-3375
1259 Highland Dr
Washington, NC 27889
Phone (252) 243-0072
2001 S 17th St
#101
Wilmington, NC 28401
Phone (910) 763-8184
4815 Oleander Dr
Ste 200
Wilmington, NC 28403
Phone (910) 313-3077
4815 Oleander Dr
Wilmington, NC 28403
Phone (910) 313-3077
Organizations & group practices 5
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.
-
- Physical Therapy Clinic/Center
- Charlotte, NC
- NPI 1568468502
-
- Physical Therapy Clinic/Center
- Charlotte, NC
- NPI 1669432175
-
- Physical Therapy Clinic/Center
- Washington, NC
- NPI 1235895152
-
- Physical Therapy Clinic/Center
- Raleigh, NC
- NPI 1689679433
-
- Physical Therapy Clinic/Center
- Ashland, VA
- NPI 1174591218
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154430213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4614 WHITEWELD TER",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284125205",
"telephone_number": "910-313-0730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 S 17TH ST",
"address_2": "STE 101",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284016628",
"telephone_number": "970-763-8184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "8519",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.