NPIMap

Organization Active NPI

Carolina Physical Therapy Associates LLC

Doing business as CORA Physical Therapy - Leesville

  • Rehabilitation Clinic/Center
  • Raleigh, NC
National Provider Identifier
1386121606
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
CAROLINA PHYSICAL THERAPY ASSOCIATES LLC
Doing business as
CORA Physical Therapy - Leesville
Practice address
13200 Strickland Rd Ste 134
Raleigh, NC 27613-5214
Phone
(919) 557-3017
Fax
(919) 557-3748
NPI assigned
Jul 20, 2018
Last updated
Jul 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Authorized official

Name
Mr. Brad C Roush
Title
Executive Vice President
Phone
(419) 221-6712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

13200 Strickland Rd Ste 134
Raleigh, NC 27613-5214

Mailing address

1110 Shawnee Rd
Lima, OH 45805-3529
Phone (419) 221-6720

Other names 1

  • CORA Physical Therapy - Leesville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170714002357 NC Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7012989684 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Apex, NC; Chapel Hill, NC; Dunn, NC; Fuquay Varina, NC; Raleigh, NC

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

13200 Strickland Rd
Ste 134
Raleigh, NC 27613
Phone (919) 246-5845

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1386121606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SHAWNEE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458053529",
            "telephone_number": "419-221-6720",
            "fax_number": "419-222-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13200 STRICKLAND RD STE 134",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276135214",
            "telephone_number": "919-557-3017",
            "fax_number": "919-557-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PHYSICAL THERAPY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "ROUSH",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "419-221-6712",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - Leesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.