Evelyn Villarreal Laclede, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP029624T Issued in NC

Practice address

2457 Gum Branch Rd # 600-800
Jacksonville, NC 28540-4008

Phone

(252) 228-4643

NPI assigned

Oct 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Evelyn Villarreal Former name

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anb-Ptsma Holdings IncGroup PAC ID 4789572926, 190 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Anb-Ptsma Holdings, Inc.

  • Physical Therapist
  • West Hartford, CT
  • NPI 1659453371
  Medicare reassignment Care Compare group NPD
• Jacksonville Peak Performance Sports & Physical Therapy, L.L.C.

  • Specialist
  • Jacksonville, NC
  • NPI 1164482402
  NPD

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710028800000",
    "number": "1326645375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2457 GUM BRANCH RD # 600-800",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2457 GUM BRANCH RD # 600-800",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404008",
            "telephone_number": "252-228-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL LACLEDE",
        "first_name": "EVELYN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2024-03-10",
        "certification_date": "2024-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1337128",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61393182",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "CP029624T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "VILLARREAL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Monika Isabella Vicario, RD, LDN
• Helen Barr Vickers, FNP
• Summer Vickers
• Carl Jason Antonil Villanueva, PT
• Valerie Villarin
• Nicholas Arlo Villasana
• Vip Lab Solutions
• Virginia Diaz Counseling & Family Therapy PLLC
• Michelle Renee Vrba, PHARMD.
• Kimberly Vrigian

• Physical Therapist in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2024; 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.