NPIMap

Organization Active NPI

Greg Ott's Center for Physical Therapy and Sports Performance, LLC

  • Physical Therapist
  • Mooresville, NC
National Provider Identifier
1427397603
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P9573 Issued in NC
Legal business name
GREG OTT'S CENTER FOR PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC
Practice address
219 Williamson Rd Ste 1104
Mooresville, NC 28117-6928
Phone
(704) 360-2364
NPI assigned
Feb 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Authorized official

Name
Amanda Streeter
Title
Vice President
Phone
(800) 699-9395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X P9573 NC Primary

Addresses

Primary practice location

219 Williamson Rd Ste 1104
Mooresville, NC 28117-6928

Mailing address

PO Box 932184
Atlanta, GA 31193-2184

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100517000233 NC Part B Supplier - Clinic/Group Practice 3274661988 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlotte, NC; Mooresville, NC; Mint Hill, NC; Huntersville, NC

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Greg Otts Center for Physical Therapy and Sports Performance LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7615 Colony Rd
Ste 110
Charlotte, NC 28226
Phone (704) 364-6793

320 Seagle St
Ste 3
Huntersville, NC 28078
Phone (704) 360-2364

4700 Lebanon Rd
Ste D2
Mint Hill, NC 28227
Phone (704) 360-2364

156 Byers Creek Rd
Mooresville, NC 28117
Phone (704) 662-3210

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1427397603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 WILLIAMSON RD STE 1104",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176928",
            "telephone_number": "704-360-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREG OTT'S CENTER FOR PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "STREETER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "800-699-9395"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P9573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.