Cathy Poulos, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1458 Issued in NC

Practice address

1140 Shipyard Blvd
Wilmington, NC 28412-6439

Phone

(910) 799-4199

NPI assigned

Apr 12, 2006

Last updated

Oct 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Physical Therapy

  • Pediatric Physical Therapist
  • Wilmington, NC
  • NPI 1285609560
  NPD (past) Authorized official

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1467416057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 RANDALL PKWY STE 2",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032590",
            "telephone_number": "910-799-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126439",
            "telephone_number": "910-799-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "CATHY",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "1458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "720777V",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "720777V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas G. Pottle, M D
• Amber Potts, LCMHCA
• Kevin Eugene Potts, MD
• Maria Anne Potts, MA, LCAS-A
• Kendra Poulin
• Amanda Poundstone, PSYD
• Chloe Powell
• Cynthia Ann Powell, PSYD
• Garlande Powell, MSW, LCSW, LCAS
• Jessica Powell, LPA LPC

• Physical Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.