Individual provider Active NPI

Jonathan Dickinson, DPT

  • Physical Therapist
  • Fuquay Varina, NC
National Provider Identifier
1275417818
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24444 Issued in NC
Practice address
100 Fitness Dr
Fuquay Varina, NC 27526-7263
Phone
(919) 557-3100
NPI assigned
Aug 5, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 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 P24444 NC Primary

Addresses

Primary practice location

100 Fitness Dr
Fuquay Varina, NC 27526-7263

Mailing address

100 Fitness Dr
Fuquay Varina, NC 27526-7263
Phone (919) 557-3100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251030000086 NC Practitioner - Physical Therapist in Private Practice 9133618127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

210 Beatty Dr
Suite 220
Belmont, NC 28012-2716
Phone (704) 500-0876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P24444NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab North Carolina LLC CurrentSince Sep 16, 2025 Accepting new patients
Ivyrehab North Carolina LLC Physical Therapist CurrentSince Sep 16, 2025 Accepting new patients

Locations

210 Beatty Dr
Ste 220
Belmont, NC 28012
Phone (704) 500-0876

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

100 Fitness Dr
Fuquay Varina, NC 27526
Phone (919) 557-3100

1878 N Broad St
Fuquay Varina, NC 27526
Phone (919) 805-3103

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": "1754352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1275417818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FITNESS DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275267263",
            "telephone_number": "919-557-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FITNESS DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275267263",
            "telephone_number": "919-557-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "JONATHAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.