Momentum PT & Wellness LTD

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

11905 Issued in NC

Legal business name

MOMENTUM PT & WELLNESS LTD

Practice address

2467 S 17TH St Unit a
Wilmington, NC 28401-7903

Phone

(910) 769-1238

Fax

(910) 777-5691

NPI assigned

Sep 15, 2013

Organization subpart

No

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

Authorized official

Name

Tyler Whiteside, DPTNPI 1619001120

Title

President

Phone

(703) 980-5570

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyler C Whiteside, DPT

  • Physical Therapist
  • Wilmington, NC
  • NPI 1619001120
  Medicare reassignment Care Compare group NPD Authorized official
• Gabrielle Marie Gentilucci

  • Physical Therapist
  • Wilmington, NC
  • NPI 1548999469
  Medicare reassignment Care Compare group NPD
• Natalie Peregory

  • Physical Therapist
  • Wilmington, NC
  • NPI 1770379372
  Medicare reassignment Care Compare group NPD
• Brandon Dale Ostrander, DPT

  • Physical Medicine & Rehabilitation Physician
  • Wilmington, NC
  • NPI 1083484224
  Medicare reassignment NPD
• Thomas James-Richard Constand, DPT

  • Physical Therapist
  • Troy, MI
  • NPI 1194423335
  NPD

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

{
    "created_epoch": "1379203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1265868814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2467 S 17TH ST UNIT A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017903",
            "telephone_number": "910-769-1238",
            "fax_number": "910-777-5691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2467 S 17TH ST UNIT A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017903",
            "telephone_number": "910-769-1238",
            "fax_number": "910-777-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM PT & WELLNESS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-15",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "WHITESIDE",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-980-5570",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NC",
            "license": "11905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "069KY",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2506019",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauryn Nicole Moffa, MS, NCC, LCMHCA
• Fazil A Mohamed II, MD
• Sarah Mojazza
• Mojo Sportclinic, LLC
• Christian William Molnar, LCSW
• Momentum Recovery LLC
• Monarc Wellness
• Monarch
• Jaclyn Moncada
• Robert Monds

• Physical Therapy Clinic/Center in Wilmington, NC
• Providers in Wilmington, 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 Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.