Organization Active NPI

Ultra Sports Performance, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
National Provider Identifier
1376309351
Registry record updated Jul 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ULTRA SPORTS PERFORMANCE, INC.
Practice address
7733 Ballantyne Commons Pkwy Ste 103
Charlotte, NC 28277-4398
Phone
(704) 236-0222
NPI assigned
Feb 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2024

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

Authorized official

Name
Dr. Kylah George, PT, DPTNPI 1306682596
Title
Physical Therapist
Phone
(704) 524-8165

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 Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

7733 Ballantyne Commons Pkwy Ste 103
Charlotte, NC 28277-4398

Mailing address

7733 Ballantyne Commons Pkwy Ste 103
Charlotte, NC 28277-4398
Phone (704) 236-0222

National Provider Directory

National Provider Directory

Locations

7733 Ballantyne Commons Pkwy
Ste 103
Charlotte, NC 28277
Phone (704) 236-0222

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720310400000",
    "number": "1376309351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7733 BALLANTYNE COMMONS PKWY STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774398",
            "telephone_number": "704-236-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 BALLANTYNE COMMONS PKWY STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774398",
            "telephone_number": "704-236-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRA SPORTS PERFORMANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-07-07",
        "certification_date": "2024-07-07",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "KYLAH",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "704-524-8165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.