NPIMap

Organization Active NPI

Physiofit Physical Therapy and Sports Performance LLC

  • Physical Therapist
  • Davidson, NC
National Provider Identifier
1215668751
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSIOFIT PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC
Practice address
460 S Main St Ste 302
Davidson, NC 28036-8006
Phone
(919) 260-7481
NPI assigned
Jun 23, 2022
Last updated
Jun 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Authorized official

Name
Chris Robert O'Connor, DPT
Title
Owner/PT
Phone
(919) 260-7481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

460 S Main St Ste 302
Davidson, NC 28036-8006

Mailing address

460 S Main St Ste 302
Davidson, NC 28036-8006
Phone (919) 260-7481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221102001033 NC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5698142776 Receives reassigned benefits from 5 practitioners
Practice locations: Davidson, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1215668751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 S MAIN ST STE 302",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368006",
            "telephone_number": "919-260-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 S MAIN ST STE 302",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368006",
            "telephone_number": "919-260-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOFIT PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "919-260-7481",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.