Organization Active NPI

KJC Corp

  • Physical Therapist
  • Chapel Hill, NC
National Provider Identifier
1497724660
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KJC CORP
Practice address
1709 Legion Rd Ste 100
Chapel Hill, NC 27517-2373
Phone
(919) 932-7266
Fax
(919) 932-7250
NPI assigned
Mar 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

Name
Deana McCollum
Title
Office Manager
Phone
(919) 932-7266

Specialties & licenses 1

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

Addresses

Primary practice location

1709 Legion Rd Ste 100
Chapel Hill, NC 27517-2373

Mailing address

1709 Legion Rd Ste 100
Chapel Hill, NC 27517-2373
Phone (919) 932-7266

Other identifiers 2

IdentifierTypeStateIssuer
DU4453OtherRAILROAD MEDICARE
013CAOtherNCBLUE CROSS OF NC

Other names 1

  • Advance Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000432 NC Part B Supplier - Clinic/Group Practice 5991617193 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Chapel Hill, NC

National Provider Directory

National Provider Directory

Locations

1709 Legion Rd
Ste 100
Chapel Hill, NC 27517
Phone (919) 932-7266

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1497724660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 LEGION RD STE 100",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275172373",
            "telephone_number": "919-932-7266",
            "fax_number": "919-932-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 LEGION RD STE 100",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275172373",
            "telephone_number": "919-932-7266",
            "fax_number": "919-932-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KJC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "MCCOLLUM",
        "authorized_official_first_name": "DEANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "919-932-7266"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DU4453",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NC",
            "identifier": "013CA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.