Medical Athletics LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

MEDICAL ATHLETICS LLC

Practice address

8535 Cliff Cameron Dr
Suite 116
Charlotte, NC 28269-5908

Phone

(704) 557-0132

Fax

(877) 284-0039

NPI assigned

Jun 13, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Shadawn Stokes, MHSA

Title

Senior Executive for Healthcare Adm

Phone

(704) 557-0132

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1528320702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 PROSPERITY CHURCH RD",
            "address_2": "SUITE I #174",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697197",
            "telephone_number": "704-557-0132",
            "fax_number": "877-284-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8535 CLIFF CAMERON DR",
            "address_2": "SUITE 116",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282695908",
            "telephone_number": "704-557-0132",
            "fax_number": "877-284-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ATHLETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "SHADAWN",
        "authorized_official_title_or_position": "SENIOR EXECUTIVE FOR HEALTHCARE ADM",
        "authorized_official_telephone_number": "704-557-0132",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.