Individual provider Active NPI

Leah Racz, P.T.

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1417018474
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11641 Issued in NC
Practice address
10616 Metromont Pkwy
Suite 102
Charlotte, NC 28269-7656
Phone
(704) 597-7228
Fax
(704) 597-9190
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5906-024 WI
Physical Therapist 225100000X 11641 NC Primary

Addresses

Primary practice location

10616 Metromont Pkwy
Suite 102
Charlotte, NC 28269-7656

Mailing address

5516 Old Town LN
Gastonia, NC 28056-8588
Phone (704) 879-4630

Other identifiers 1

IdentifierTypeStateIssuer
40304300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11641NCMDOral & Maxillofacial Surgery (D.M.D.)
5906-024WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1417018474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5516 OLD TOWN LN",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280568588",
            "telephone_number": "704-879-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10616 METROMONT PKWY",
            "address_2": "SUITE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697656",
            "telephone_number": "704-597-7228",
            "fax_number": "704-597-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACZ",
        "first_name": "LEAH",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5906-024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "11641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40304300",
            "state": "WI"
        }
    ],
    "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 Feb 11, 2009; 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.