NPIMap

Organization Active NPI

Synergy Physical Therapy & Sports Medicine LLC

  • Physical Therapy Clinic/Center
  • Jacksonville, NC
National Provider Identifier
1326300013
Registry record updated Jun 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SYNERGY PHYSICAL THERAPY & SPORTS MEDICINE LLC
Practice address
233 Bell Fork Rd
Jacksonville, NC 28540-6471
Phone
(252) 349-9090
NPI assigned
Jun 9, 2012
Last updated
Jun 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2012

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

Authorized official

Name
Mrs. Kira Porter Boyd, MSPT, ATCNPI 1205809449
Title
Clinic Director/Owner
Phone
(252) 626-0888

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 NC Primary

Addresses

Primary practice location

233 Bell Fork Rd
Jacksonville, NC 28540-6471

Mailing address

220 Bluewater CV
Cape Carteret, NC 28584-9401
Phone (252) 349-9090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120926000002 NC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7911156559 Receives reassigned benefits from 13 practitioners
Practice locations: Jacksonville, NC

National Provider Directory

National Provider Directory

Locations

233 Bell Fork Rd
Jacksonville, NC 28540
Phone (252) 349-9090

233 Bell Fork Rd
#E
Jacksonville, NC 28540
Phone (910) 238-2259

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1339200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339200000000",
    "number": "1326300013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BLUEWATER CV",
            "city": "CAPE CARTERET",
            "state": "NC",
            "postal_code": "285849401",
            "telephone_number": "252-349-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 BELL FORK RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406471",
            "telephone_number": "252-349-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY PHYSICAL THERAPY & SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-09",
        "last_updated": "2012-06-09",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "KIRA",
        "authorized_official_middle_name": "PORTER",
        "authorized_official_title_or_position": "CLINIC DIRECTOR/OWNER",
        "authorized_official_telephone_number": "252-626-0888",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSPT, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 9, 2012; 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.