Active NPI
Marissa Delaurentiis, PT, DPT
- Physical Therapist
- Waxhaw, NC
National Provider Identifier
1538910476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P23093
- Practice address
- 1229 Toteros Dr
Waxhaw, NC 28173-6950 - Phone
- (704) 649-4509
- NPI assigned
- Mar 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P23093 | NC | Primary |
Addresses
Primary practice location
1229 Toteros Dr
Waxhaw, NC 28173-6950
Mailing address
13029 Asheford Woods LN
Charlotte, NC 28278-7845
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P23093 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milestone Therapy Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1538910476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13029 ASHEFORD WOODS LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282787845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 TOTEROS DR",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281736950",
"telephone_number": "704-649-4509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELAURENTIIS",
"first_name": "MARISSA",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-28",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P23093",
"primary": true
}
],
"identifiers": [],
"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 Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.