Individual provider Active NPI

Peter Olmos

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1447324769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2605 Blue Ridge Rd Ste 230
Raleigh, NC 27607-6475
Phone
(919) 781-1637
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

2605 Blue Ridge Rd Ste 230
Raleigh, NC 27607-6475

Mailing address

621 Edinborough Dr
Durham, NC 27703-8495
Phone (919) 941-6034

Other identifiers 1

IdentifierTypeStateIssuer
P10775OtherNCLICENSE#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141218002412 NC Practitioner - Physical Therapist in Private Practice 1658445507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Sprunt St
Chapel Hill, NC 27517-7811
Phone (984) 974-2560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina Hospitals at Chapel Hill Current Accepting new patients
University of North Carolina Hospitals at Chapel Hill Physical Therapist CurrentSince Aug 1, 2014 Accepting new patients
University of North Carolina Hospitals at Chapel Hill CurrentSince Aug 1, 2014 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Past Accepting new patients

Locations

350 Stonecroft Ln
Cary, NC 27519
Phone (919) 957-5908

1350 Raleigh Rd
Chapel Hill, NC 27517
Phone (984) 974-4110

100 Sprunt St
Chapel Hill, NC 27517
Phone (919) 843-2164

Organizations & group practices 4

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447324769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 EDINBOROUGH DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277038495",
            "telephone_number": "919-941-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 BLUE RIDGE RD STE 230",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076475",
            "telephone_number": "919-781-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMOS",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "P10775",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.