NPIMap

Organization Active NPI

Milestone Therapy Inc

  • Occupational Therapist
  • Waxhaw, NC
National Provider Identifier
1487824405
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
MILESTONE THERAPY INC
Practice address
2300 Gallberry LN
Waxhaw, NC 28173-0161
Phone
(704) 649-4509
Fax
(704) 843-9045
NPI assigned
Mar 5, 2008
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Mr. Philip Joseph Bissoondial, OTR/LNPI 1578682225
Title
President
Phone
(704) 649-4509

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU Primary
Speech-Language Pathologist 235Z00000X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

2300 Gallberry LN
Waxhaw, NC 28173-0161

Mailing address

2300 Gallberry LN
Waxhaw, NC 28173-0161
Phone (704) 649-4509

Other identifiers 2

IdentifierTypeStateIssuer
7200201MedicaidNC
NPC106MedicaidSC

National Provider Directory

National Provider Directory

Locations

741 Kenilworth Ave
Ste 100
Charlotte, NC 28204
Phone (704) 523-8027

Practitioners & affiliated clinicians

Practitioners 96

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 96

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1487824405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GALLBERRY LN",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281730161",
            "telephone_number": "704-649-4509",
            "fax_number": "704-843-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GALLBERRY LN",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281730161",
            "telephone_number": "704-649-4509",
            "fax_number": "704-843-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "BISSOONDIAL",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-649-4509",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200201",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPC106",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.