Individual provider Active NPI

Stephanie Beneville, PT

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1366453789
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P12088 Issued in NC
Practice address
6753 Wheeler Dr
Charlotte, NC 28211-4760
Phone
(704) 408-9341
NPI assigned
Aug 10, 2006
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P12088 NC Primary

Addresses

Primary practice location

6753 Wheeler Dr
Charlotte, NC 28211-4760

Mailing address

4908 Doris Ave
Charlotte, NC 28205-7810
Phone (704) 408-9341

Other identifiers 2

IdentifierTypeStateIssuer
2305204757OtherVASTATE LICENSE
P12088OtherNCNORTH CAROLINA BOARD OF PT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241125003980 NC Practitioner - Physical Therapist in Private Practice 4880797505 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Connecticut School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians
Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians
Integrated Therapy LLCGroup PAC ID 1153317300, 48 clinicians

Practice addresses (Care Compare)

2147 Davie Ave
Statesville, NC 28625-9200
Phone (704) 994-5065

3600 Park Rd
Charlotte, NC 28209-4102
Phone (980) 203-3585

800 E M L K Jr Blvd
Charlotte, NC 28202
Phone (404) 351-5307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P12088NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Collective Therapy Corp. Physical Therapist CurrentSince Jan 7, 2025 Accepting new patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince Nov 3, 2025 Accepting new patients
Integrated Therapy LLC Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince Nov 3, 2025 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jan 12, 2026 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jan 12, 2026 Accepting new patients
Life Clinic of NC PC Physical Therapist PastSince Nov 4, 2024 Accepting new patients
Phoenix Rehabilitation and Health Services of Virginia, LLC Physical Therapist PastSince Apr 4, 2005 Accepting new patients

Locations

2221 Peachtree Rd NE
Ste D336
Atlanta, GA 30309

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

1700 Regency Pkwy
Cary, NC 27518
Phone (404) 351-5309

8919 Park Rd
Charlotte, NC 28210
Phone (704) 384-1225

800 E Martin Luther King Blvd
Charlotte, NC 28202

11220 Golf Links Dr
Charlotte, NC 28277
Phone (704) 510-4988

2147 Davie Ave
Statesville, NC 28625
Phone (704) 878-0123

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1366453789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 DORIS AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057810",
            "telephone_number": "704-408-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6753 WHEELER DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114760",
            "telephone_number": "704-408-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEVILLE",
        "first_name": "STEPHANIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P12088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2305204757",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF PT",
            "identifier": "P12088",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "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 Sep 16, 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.