Individual provider Active NPI

David Charles Reed III, PT

  • Physical Therapist
  • Mint Hill, NC
National Provider Identifier
1194127969
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P13678 Issued in NC
Practice address
7900 Matthews Mint Hill Rd Ste 107E
Mint Hill, NC 28227-6567
Phone
(704) 774-2114
Fax
(704) 565-4285
NPI assigned
Sep 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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 5501012444 MI
Physical Therapist 225100000X P13678 NC Primary

Addresses

Primary practice location

7900 Matthews Mint Hill Rd Ste 107E
Mint Hill, NC 28227-6567

Mailing address

7900 Matthews Mint Hill Rd Ste 107E
Mint Hill, NC 28227-6567
Phone (704) 774-2114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141216001781 NC Practitioner - Physical Therapist in Private Practice 1850614207 Reassigns benefits to 1 organization
I20201116001792 SC Practitioner - Physical Therapist in Private Practice 1850614207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Wayne State University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Origin Rehabilitation, LLCGroup PAC ID 7012339468, 2 clinicians

Practice addresses (Care Compare)

102 Cotton Bay Way
Simpsonville, SC 29681-4374
Phone (704) 774-2114

7900 Matthews Mint Hill Rd
Suite 300
Mint Hill, NC 28227-6566
Phone (704) 905-1333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501012444MIMDPhysical Therapist
P13678NCMDPhysical Therapist
9534SCMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Origin Rehabilitation, LLC Physical Therapist CurrentSince Jun 1, 2020 Accepting new patients
Bluewater Physician Services Past Accepting new patients
Physiatry Consultants of NC PLLC PastSince Mar 1, 2021 Accepting new patients

Locations

7900 Matthews Mint Hill Rd
Ste 300
Mint Hill, NC 28227
Phone (704) 905-1333

7900 Matthews Mint Hill Rd
Ste 107E
Mint Hill, NC 28227
Phone (704) 905-1333

Organizations & group practices 3

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1194127969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 MATTHEWS MINT HILL RD STE 107E",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282276567",
            "telephone_number": "704-774-2114",
            "fax_number": "704-565-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 MATTHEWS MINT HILL RD STE 107E",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282276567",
            "telephone_number": "704-774-2114",
            "fax_number": "704-565-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "DAVID",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012444",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P13678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mint Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.