NPIMap

Organization Active NPI

Youngs Physical Therapy & Sports Rehab, Inc.

  • Physical Therapy Clinic/Center
  • Greenville, NC
National Provider Identifier
1306192141
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
9823 Issued in NC
Legal business name
YOUNGS PHYSICAL THERAPY & SPORTS REHAB, INC.
Practice address
1301 E Arlington Blvd
Greenville, NC 27858-5868
Phone
(252) 565-8812
Fax
(252) 565-8812
NPI assigned
Jul 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Authorized official

Name
Aaron Park Fuller, LAT, ATCNPI 1720494040
Title
Director of Operations
Phone
(252) 565-8812

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 9823 NC Primary

Addresses

Primary practice location

1301 E Arlington Blvd
Greenville, NC 27858-5868

Mailing address

1301 E Arlington Blvd
Greenville, NC 27858-5868
Phone (252) 565-8812

Other names 1

  • Youngs Physical Therapy & Sports Performance Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120815000150 NC Part B Supplier - Clinic/Group Practice 6507012101 Receives reassigned benefits from 23 practitioners
Practice locations: Greenville, NC; Morehead City, NC

National Provider Directory

National Provider Directory

Locations

518 Greenville Blvd SE
Ste B
Greenville, NC 27858
Phone (252) 565-8812

1301 E Arlington Blvd
Greenville, NC 27858
Phone (252) 565-8812

4219 Arendell St
Ste C
Morehead City, NC 28557
Phone (252) 565-8812

Practitioners & affiliated clinicians

Practitioners 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1306192141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585868",
            "telephone_number": "252-565-8812",
            "fax_number": "252-565-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585868",
            "telephone_number": "252-565-8812",
            "fax_number": "252-565-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNGS PHYSICAL THERAPY & SPORTS REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-30",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "PARK",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "252-565-8812",
        "authorized_official_credential": "LAT, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NC",
            "license": "9823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youngs Physical Therapy & Sports Performance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.