Individual provider Active NPI

Eileen R Carter, PT, MBA

  • Physical Therapist
  • Wilson, NC
National Provider Identifier
1376581777
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1870 Issued in NC
Practice address
1811 Forest Hills Rd W
Wilson, NC 27893-3412
Phone
(252) 243-7400
Fax
(252) 243-3291
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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 1870 NC Primary

Addresses

Primary practice location

1811 Forest Hills Rd W
Wilson, NC 27893-3412

Mailing address

2400 Runnymeade Rd NW
Wilson, NC 27896-1350
Phone (252) 237-2414

Other identifiers 2

IdentifierTypeStateIssuer
720777YMedicaidNC
0777YOtherNCBCBS GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231024000423 NC Practitioner - Physical Therapist in Private Practice 4385547371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Rehab of Wilson, Inc. Physical Therapist CurrentSince Oct 29, 2002 Accepting new patients

Locations

1811 Forest Hills Rd W
Wilson, NC 27893
Phone (252) 243-7400

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1376581777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 RUNNYMEADE RD NW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278961350",
            "telephone_number": "252-237-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 FOREST HILLS RD W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933412",
            "telephone_number": "252-243-7400",
            "fax_number": "252-243-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "EILEEN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PT, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "1870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "720777Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0777Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; 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.