Individual provider Active NPI

Taylar Rose Zubko

  • Physical Therapist
  • Wake Forest, NC
National Provider Identifier
1174497754
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24416 Issued in NC
Practice address
1628 S Main St Ste 104
Wake Forest, NC 27587-2593
Phone
(919) 342-1357
NPI assigned
Oct 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT42115 FL
Physical Therapist 225100000X P24416 NC Primary

Addresses

Primary practice location

1628 S Main St Ste 104
Wake Forest, NC 27587-2593

Mailing address

1628 S Main St Ste 104
Wake Forest, NC 27587-2593
Phone (919) 342-1357

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251110003912 NC Practitioner - Physical Therapist in Private Practice 2567952229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

1628 S Main St
Suite 104
Wake Forest, NC 27587-8816
Phone (919) 342-1357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT42115FLMDPhysical Therapist
P24416NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab North Carolina LLC Physical Therapist CurrentSince Oct 14, 2025 Accepting new patients
Ivyrehab North Carolina LLC CurrentSince Oct 14, 2025 Accepting new patients

Locations

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

1628 S Main St
Ste 104
Wake Forest, NC 27587
Phone (919) 342-1357

Organizations & group practices 2

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": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1174497754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 S MAIN ST STE 104",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872593",
            "telephone_number": "919-342-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 S MAIN ST STE 104",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872593",
            "telephone_number": "919-342-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUBKO",
        "first_name": "TAYLAR",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42115",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.