Ian Ques, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P21752 Issued in NC

Practice address

4501 Main St
Shallotte, NC 28470-4589

Phone

(910) 755-5863

NPI assigned

Jun 5, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Sports Medicine IncGroup PAC ID 9234523127, 2 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.

• Premier Sports Medicine, Inc.

  • General Practice Physician
  • Soldotna, AK
  • NPI 1659846293
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1346934452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 POCAHONTAS DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325473283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 MAIN ST",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704589",
            "telephone_number": "910-755-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUES",
        "first_name": "IAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin David Price, DO
• Sheila Joyce Priestly, P.T.
• Clark E Pritts, DO
• Megan Pruett
• Whitney Boni Pruitt, AGNP
• Rocky Carol Quillen, PA
• Alyssa Nicole Racanelli
• Raleigh Durham Medical Group PA (Seaside Wellness of Shallotte)
• Raleigh Durham Medical Group, PA (Seaside Wellness of Shallotte)
• Babysarojah Ravindran, MD

• Physical Therapist in Shallotte, NC
• Providers in Shallotte, 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 Jun 5, 2023; 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.