Benjamin Tillman Alexander IV, PT, DPT
Individual provider Active NPI Physical Therapist · Holly Springs, NC
NPI 1194100297 · NPPES record last updated Jul 30, 2015
Key facts
- NPI
- 1194100297
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- P15785 (NC)
- Practice address
- 251 W Center St
Holly Springs, NC 27540-5900 - Phone
- (919) 577-9200
- Fax
- (919) 577-9292
- NPI assigned
- Jul 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Village Health and Fitness
Practice addresses (Care Compare)
1006 Broad St
Oriental, NC 28571-9784
Phone (252) 249-1051
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151002002608 | NC | Practitioner - Physical Therapist in Private Practice | 0244548675 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Health & Fitness | Current |
Accepting new patients |
Locations
1006 Broad St
Oriental, NC 28571
Phone (252) 249-1051
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P15785 | NC | Yes |
Addresses
Primary practice location
251 W Center St
Holly Springs, NC 27540-5900
Mailing address
251 W Center St
Holly Springs, NC 27540-5900
Phone (919) 577-9200
Other providers in Holly Springs, NC
- Feyisayo Adenike Adeyina
- Pamela Lavern-Pinnix Adkins
- Agilitas USA, Inc
- Ryann Akolkar
- Alcon J Group
- Lumar Alicea
- Katie Tart Allen
- Amd Counseling and Consulting, PLLC
- Fran Ammons
- Anderson Chiropractic, PLLC
All providers in Holly Springs, 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 Jul 30, 2015. 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.