Laurel H Mogensen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13232 Issued in NC

Practice address

1100 Blythe Blvd
Charlotte, NC 28203-5814

Phone

(704) 355-4645

Fax

(704) 355-4231

NPI assigned

Jul 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Laurel A Holberton Former name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Atrium Health Specialty Network Inc

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1538975636

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1225326259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035814",
            "telephone_number": "704-355-4645",
            "fax_number": "704-355-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035814",
            "telephone_number": "704-355-4645",
            "fax_number": "704-355-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGENSEN",
        "first_name": "LAUREL",
        "middle_name": "H",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "13232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "HOLBERTON",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jaime Leigh Moffett, LCSW
• Janey M Moffett
• Rachel Page Moffett, DO
• Edward R Mogabgab, M.D.
• Daniel J Mogensen, D.P.T
• Radhia A Mogoma, PT
• Dalia Mohamed
• Qamar Mohamed
• Rasha Hussein Mohamed, PH.D, LCMHC
• Waheed V Mohamed, DDS MD

• Physical Therapist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.