Mary Tracey Alyson Kavanaugh, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P9204 Issued in NC

Practice address

14330 Oakhill Park LN Ste 115
Huntersville, NC 28078-3479

Phone

(704) 316-1280

Fax

(704) 316-1266

NPI assigned

Apr 23, 2010

Last updated

Feb 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Foundation Health Systems LLC

  dba Novant Health Rehabilitation Center

  • Physical Therapy Clinic/Center
  • Winston Salem, NC
  • NPI 1205894029

  Physical Therapist

  NPD (past)
• The Presbyterian Hospital

  dba Novant Health Infusion

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1740169820
  NPD (past)

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1558688010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791",
            "telephone_number": "704-316-1266",
            "fax_number": "704-316-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14330 OAKHILL PARK LN STE 115",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783479",
            "telephone_number": "704-316-1280",
            "fax_number": "704-316-1266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10030 Gilead Rd",
            "address_2": "Suite B100",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787545",
            "country_code": "US",
            "telephone_number": "704-316-5500",
            "fax_number": "704-316-2463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "MARY TRACEY",
        "middle_name": "ALYSON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P9204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albert Kaplan, PT
• Heidi B. Karant, OTR/L
• Kardi Bilingual Therapy, PLLC (KarDi Bilingual Consulting)
• Elsa Aguilar Kasell, P.A.
• Harika Kavalipati, PT
• Kris Kawulok, MA, NCC, LPCA
• Dajen Runge Keefer Williams, PHARMD
• Keith a. Kye, DDS
• Lisa Christine Kelley, MA, LCMHCS
• Taylor Marie Kelly, DC

• Physical Therapist in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.