Mikaela Maddock, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P18708 Issued in NC

Practice address

9111 Monroe Rd Ste 100
Charlotte, NC 28270-2460

Phone

(704) 847-3911

NPI assigned

Jun 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Crossway, Inc.

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1851335459

  Physical Therapist

  NPD (past)
• Complete Rehabilitation and Sports Physical Therapy, PC

  • Physical Therapist
  • Ronkonkoma, NY
  • NPI 1811097306
  NPD (past)

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1245899194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9413 WENLOCK CIR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282701428",
            "telephone_number": "716-200-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 MONROE RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282702460",
            "telephone_number": "704-847-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOCK",
        "first_name": "MIKAELA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "P18708",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P18708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Ihne Madaris, OD
• Vanessa Madden-Gilyard, FNP-BC
• Caroline Margaret Madden, PNP-PC
• Debra Cook Madden, LCAS
• Larissa Madden
• Jennifer Maddox
• Vinaya Chandra Maddukuri, M.D.
• Mackenzie Peyton Maddy
• Erica Madera, MA, BCBA, LBA
• Jason Madey, 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 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.