Colleen Rollo, PT, DPT GCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P15217 Issued in NC

Practice address

1502 Castle St
Wilmington, NC 28401-5521

Phone

(978) 335-7640

NPI assigned

Nov 18, 2016

Reactivated

Oct 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Paradigm Performance Therapy LLC

  • Physical Therapy Clinic/Center
  • Wilmington, NC
  • NPI 1346912888
  NPD Authorized official

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1164965422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7515 PETERS LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118380",
            "telephone_number": "978-335-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 CASTLE ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284015521",
            "telephone_number": "978-335-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLO",
        "first_name": "COLLEEN",
        "credential": "PT, DPT GCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "deactivation_date": "2021-10-07",
        "reactivation_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P15217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela M Rogers, NPC
• Carla Dibenedetto Rohena, PA
• Melanie Rezende Rojas, MD
• Alison Roller-Alling, PMHNP-BC
• Jennifer Nicole Rollin, PA
• Clare Nicole Rolquin, MSW, LCSW-A, LCAS-A
• Kennedi Anna Roman, DO
• Michelle Ann Roman, PA-C
• Lynanne Romano, PSY.D.
• Michael Charles Romig, DO

• Physical Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.