Active NPI
Anusha Madanamohan, PHYSICAL THERAPIST
- Geriatric Physical Therapist
- Charlotte, NC
National Provider Identifier
1285002253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- P15694
- Practice address
- 2415 Sandy Porter Rd
Charlotte, NC 28273-3695 - Phone
- (704) 583-0430
- NPI assigned
- Sep 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Geriatric Physical Therapist | 2251G0304X | P15694 | NC | Primary |
Addresses
Primary practice location
2415 Sandy Porter Rd
Charlotte, NC 28273-3695
Mailing address
9604 Woburn Rd
Charlotte, NC 28277-1967
Phone (980) 322-7374
Other practice location 1
1785 Lexington Commons Dr
Rock Hill, SC 29732-3528
Phone (803) 207-8000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | N/A | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P15694 | NC | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713830400000",
"number": "1285002253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9604 WOBURN RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282771967",
"telephone_number": "980-322-7374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 SANDY PORTER RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282733695",
"telephone_number": "704-583-0430"
}
],
"practiceLocations": [
{
"address_1": "1785 Lexington Commons Dr",
"address_purpose": "LOCATION",
"city": "Rock Hill",
"state": "SC",
"postal_code": "297323528",
"country_code": "US",
"telephone_number": "803-207-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MADANAMOHAN",
"first_name": "ANUSHA",
"name_prefix": "Mrs.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-08",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "NC",
"license": "P15694",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "N/A",
"affiliation": "N",
"endpointDescription": "N/A",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "N/A",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "N/A",
"address_1": "2415 Sandy Porter Rd",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282733695",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.