Active NPI
Thomas Nelson Teixeira, PT
- Geriatric Physical Therapist
- Shallotte, NC
National Provider Identifier
1245438902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 3980
- Practice address
- 120 Shallotte Crossing Pkwy
Suite 5 Box 202
Shallotte, NC 28470-8117 - Phone
- (336) 491-5022
- NPI assigned
- Jul 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 5399 | NC | |
| Geriatric Physical Therapist | 2251G0304X | 3980 | NC | Primary |
Addresses
Primary practice location
120 Shallotte Crossing Pkwy
Suite 5 Box 202
Shallotte, NC 28470-8117
Mailing address
120 Shallotte Crossing Pkwy
Suite5 Box 202
Shallotte, NC 28470-8117
Phone (336) 491-5022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3980 | NC | MD | Mental Health Counselor |
| 5399 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245438902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 SHALLOTTE CROSSING PKWY",
"address_2": "SUITE5 BOX 202",
"city": "SHALLOTTE",
"state": "NC",
"postal_code": "284708117",
"telephone_number": "336-491-5022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 SHALLOTTE CROSSING PKWY",
"address_2": "SUITE 5 BOX 202",
"city": "SHALLOTTE",
"state": "NC",
"postal_code": "284708117",
"telephone_number": "336-491-5022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEIXEIRA",
"first_name": "THOMAS",
"middle_name": "NELSON",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "NC",
"license": "5399",
"primary": false
},
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "NC",
"license": "3980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shallotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.