Balanced Physical Therapy & Sports Performance

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BALANCED PHYSICAL THERAPY & SPORTS PERFORMANCE

Practice address

6520 Falls of Neuse Rd Ste 110
Raleigh, NC 27615-6849

Phone

(919) 803-1037

NPI assigned

Dec 12, 2019

Last updated

Dec 12, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Fultineer, PT

Title

Owner/Physical Therapist

Phone

(919) 803-1037

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1255979035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 KINLAWTON PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276149867",
            "telephone_number": "717-615-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 FALLS OF NEUSE RD STE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156849",
            "telephone_number": "919-803-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED PHYSICAL THERAPY & SPORTS PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "FULTINEER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "919-803-1037",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teena Baker, LPC-A
• Tierra Baker
• Rebecca Olson Bakkestuen, PAC
• Stacey Bala, MS, RD, LDN
• Balanced Change Nutrition and Wellness (Balanced Change)
• Joelle Balcita
• Baldwin Counseling & Consulting Services
• Amber Shavon Baldwin
• Arlisha Baldwin
• Bradley Baldwin, AUD

• Physical Therapy Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physical Therapy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.