Individual provider Active NPI

Rahsan Demarcus McMillan, PT, DPT

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1417418039
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3627 Beatties Ford Rd
Charlotte, NC 28216-3249
Phone
(704) 394-6677
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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 Primary

Addresses

Primary practice location

3627 Beatties Ford Rd
Charlotte, NC 28216-3249

Mailing address

642 Northway Dr
Charlotte, NC 28208-2239
Phone (980) 722-4722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210121001206 NC Practitioner - Physical Therapist in Private Practice 8628482395 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Oct 1, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 1, 2025 Accepting new patients
Atrium Health Specialty Network Inc Physical Therapist CurrentSince Oct 1, 2025 Accepting new patients
North Carolina Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 4, 2023 Accepting new patients
Sports and Spine Physical Therapy NC Inc Physical Therapist Past Accepting new patients
Bomray Medical Clinic PastSince Sep 16, 1996 Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4525 Cameron Valley Pkwy
Charlotte, NC 28211
Phone (704) 355-5100

1090 NE Gateway Ct NE
Ste 204A
Concord, NC 28025
Phone (704) 403-9100

9726 Sam Furr Rd
Huntersville, NC 28078
Phone (704) 801-3310

1401 Matthews Township Pkwy
Ste 225
Matthews, NC 28105
Phone (704) 841-2104

Organizations & group practices 7

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1417418039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 NORTHWAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282082239",
            "telephone_number": "980-722-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 BEATTIES FORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282163249",
            "telephone_number": "704-394-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "RAHSAN",
        "middle_name": "DEMARCUS",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "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 Mar 27, 2019; 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.