Organization Active NPI

Osteo Health and Balance Inc

  • Physical Therapy Clinic/Center
  • Southport, NC
National Provider Identifier
1407339534
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
OSTEO HEALTH AND BALANCE INC
Practice address
4330 Southport Supply Rd Ste 103
Southport, NC 28461-9265
Phone
(910) 363-4222
Fax
(910) 477-6336
NPI assigned
Sep 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Authorized official

Name
Joan Bray, DPT
Title
Owner/Operator
Phone
(919) 995-0255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

4330 Southport Supply Rd Ste 103
Southport, NC 28461-9265

Mailing address

4330 Southport Supply Rd
Ste 103
Southport, NC 28461-9265
Phone (910) 363-4222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191112000012 NC Part B Supplier - Clinic/Group Practice 9032541149 Receives reassigned benefits from 1 practitioner
Practice locations: Southport, NC

National Provider Directory

National Provider Directory

Locations

4330 Southport Supply Rd SE
Ste 103
Southport, NC 28461
Phone (910) 363-4222

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": "1536883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1407339534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 SOUTHPORT SUPPLY RD",
            "address_2": "STE 103",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619265",
            "telephone_number": "910-363-4222",
            "fax_number": "910-477-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 SOUTHPORT SUPPLY RD STE 103",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619265",
            "telephone_number": "910-363-4222",
            "fax_number": "910-477-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSTEO HEALTH AND BALANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-14",
        "last_updated": "2024-03-13",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "BRAY",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "919-995-0255",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.