Individual provider Active NPI

Charles Allen Farquhar, PT

  • Physical Therapist
  • Florence, AL
National Provider Identifier
1487979902
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH5799 Issued in AL
Practice address
1751 Veterans Dr Ste 300
Florence, AL 35630-4930
Phone
(256) 764-9304
Fax
(256) 764-9343
NPI assigned
Mar 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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 PTH5799 AL Primary

Addresses

Primary practice location

1751 Veterans Dr Ste 300
Florence, AL 35630-4930

Mailing address

1751 Veterans Dr Ste 300
Florence, AL 35630-4930
Phone (256) 764-9304

Other practice location 1

104 Physicians Dr Ste C
Muscle Shoals, AL 35661-2100
Phone (256) 764-9304

Other identifiers 1

IdentifierTypeStateIssuer
179008MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110209000263 AL Practitioner - Physical Therapist in Private Practice 6709066749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Alabama School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab and Sports Medicine of the Shoals, IncGroup PAC ID 6204854482, 8 clinicians

Practice addresses (Care Compare)

1751 Veterans Dr
Suite 300
Florence, AL 35630-4930
Phone (256) 764-9304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH5799ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab and Sports Medicine of the Shoals, Inc CurrentSince Oct 1, 2010 Accepting new patients
Select Physical Therapy Holdings Inc Past Accepting new patients

Locations

2129 Helton Dr
Ste C
Florence, AL 35630
Phone (256) 764-9304

1751 Veterans Dr
Ste 300
Florence, AL 35630
Phone (256) 718-3200

104 Physicians Dr
Ste C
Muscle Shoals, AL 35661
Phone (256) 246-3490

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1487979902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 VETERANS DR STE 300",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356304930",
            "telephone_number": "256-764-9304",
            "fax_number": "256-764-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 VETERANS DR STE 300",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356304930",
            "telephone_number": "256-764-9304",
            "fax_number": "256-764-9343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Physicians Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Muscle Shoals",
            "state": "AL",
            "postal_code": "356612100",
            "country_code": "US",
            "telephone_number": "256-764-9304",
            "fax_number": "256-764-9343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARQUHAR",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH5799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179008",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.