Individual provider Active NPI

Hayden Lundahl Liles, DPT

  • Physical Therapist
  • Cary, NC
National Provider Identifier
1255005922
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P20631 Issued in NC
Practice address
570 New Waverly PL Ste 120
Cary, NC 27518-7405
Phone
(919) 803-3398
NPI assigned
Aug 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P20631 NC Primary

Addresses

Primary practice location

570 New Waverly PL Ste 120
Cary, NC 27518-7405

Mailing address

570 New Waverly PL Ste 120
Cary, NC 27518-7405
Phone (919) 803-3398

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118001546 NC Practitioner - Physical Therapist in Private Practice 3072902758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina Institute of Sports Biomechanics LLCGroup PAC ID 8022238658, 14 clinicians

Practice addresses (Care Compare)

570 New Waverly PL
Suite 120
Cary, NC 27518-7405
Phone (919) 372-8412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P20631NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina Institute of Sports Biomechanics, LLC CurrentSince Aug 5, 2021 Accepting new patients

Locations

2121 E Williams St
Ste 108
Apex, NC 27539
Phone (919) 372-8412

570 New Waverly Pl
Ste 120
Cary, NC 27518
Phone (919) 372-8412

Organizations & group practices 1

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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1255005922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 NEW WAVERLY PL STE 120",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187405",
            "telephone_number": "919-803-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 NEW WAVERLY PL STE 120",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187405",
            "telephone_number": "919-803-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "HAYDEN",
        "middle_name": "LUNDAHL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.