Individual provider Active NPI

Madeleine Thomas, DPT, PT

  • Physical Therapist
  • Jacksonville, NC
National Provider Identifier
1275116402
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2756 Richlands Hwy
Jacksonville, NC 28540-3611
Phone
(910) 378-0147
Fax
(910) 219-4119
NPI assigned
May 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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 Primary

Addresses

Primary practice location

2756 Richlands Hwy
Jacksonville, NC 28540-3611

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395
Phone (616) 356-5000

Other practice location 1

5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631
Phone (757) 455-5000

Other names 1

  • Madeleine McCarty Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241105003165 CA Practitioner - Physical Therapist in Private Practice 0244631174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Sports and Physical Therapy, LLC Physical Therapist CurrentSince Dec 10, 2023 Accepting new patients
Jacksonville Peak Performance Sports & Physical Therapy, L.L.C. CurrentSince Dec 10, 2023 Accepting new patients

Locations

625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546

2756 Richlands Hwy
Jacksonville, NC 28540
Phone (910) 378-0147

Organizations & group practices 2

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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1275116402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395",
            "telephone_number": "616-356-5000",
            "fax_number": "616-356-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2756 RICHLANDS HWY",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285403611",
            "telephone_number": "910-378-0147",
            "fax_number": "910-219-4119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5604 Virginia Beach Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234625631",
            "country_code": "US",
            "telephone_number": "757-455-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MADELEINE",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELEINE",
            "last_name": "MCCARTY",
            "credential": "DPT, PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.