Restore Healthcare Medical Group

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

RESTORE HEALTHCARE MEDICAL GROUP

Practice address

330 Camp Rd Ste B43
Charlotte, NC 28206-4005

Phone

(888) 661-7730

Fax

(888) 813-2442

NPI assigned

Apr 3, 2018

Organization subpart

No

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

Authorized official

Name

Christina Jarrett

Title

Executive Director

Phone

(704) 559-9409

Specialties & licenses 15

Addresses

Other identifiers 3

Other names 1

• Restore Healthcare Medical Group Other name

Electronic endpoints 1

Tax ID family

Restore Healthcare Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Restore Healthcare Medical Group

  • Customized Equipment (DME)
  • Charlotte, NC
  • NPI 1376028837
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chris Jarrett

  • Case Manager/Care Coordinator
  • Charlotte, NC
  • NPI 1033873724
  NPD

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1184120750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2764 PLEASANT RD STE 10134",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297087213",
            "telephone_number": "888-661-7730",
            "fax_number": "888-813-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CAMP RD STE B43",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282064005",
            "telephone_number": "888-661-7730",
            "fax_number": "888-813-2442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 E Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297305384",
            "country_code": "US",
            "telephone_number": "888-661-7730",
            "fax_number": "877-831-0055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4258 Highway 49 South",
            "address_2": "Unit 584",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "28075",
            "country_code": "US",
            "telephone_number": "800-661-9381",
            "fax_number": "888-813-2442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESTORE HEALTHCARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-03",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "JARRETT",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-559-9409"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224ZE0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "=========",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "=========",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED CARE PROVIDER INSURANCE",
            "identifier": "=========",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.rhcpediatrictherapy.wixsite.com/restorehealthcare",
            "affiliation": "N",
            "endpointDescription": "Website Referral Form",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Referral Forms",
            "address_1": "4258 Highway 49 South",
            "address_2": "Unit 584",
            "city": "Harrisburg",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Restore Healthcare Medical Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Restore Healthcare Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.