Individual provider Active NPI

Jennifer Christine Dyba, DPT

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1629471362
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15200 Issued in NC
Practice address
6034 Heath Valley Rd
Charlotte, NC 28210-4352
Phone
(704) 577-9937
Fax
(980) 236-8077
NPI assigned
Oct 8, 2014
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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 15200 NC Primary

Addresses

Primary practice location

6034 Heath Valley Rd
Charlotte, NC 28210-4352

Mailing address

6034 Heath Valley Rd
Charlotte, NC 28210-4352
Phone (704) 577-9937

Other practice location 1

4913 Broken Saddle Ln
Charlotte, NC 28226-5816
Phone (704) 577-9937

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

LicenseStateTypeSpecialty
15200NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Therapy Services LLC Physical Therapist CurrentSince Feb 2, 2020 Accepting new patients
Cole Consolidated Rehab LLC Past Accepting new patients

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": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1629471362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6034 HEATH VALLEY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104352",
            "telephone_number": "704-577-9937",
            "fax_number": "980-236-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6034 HEATH VALLEY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104352",
            "telephone_number": "704-577-9937",
            "fax_number": "980-236-8077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4913 Broken Saddle Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282265816",
            "country_code": "US",
            "telephone_number": "704-577-9937",
            "fax_number": "980-236-8077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYBA",
        "first_name": "JENNIFER",
        "middle_name": "CHRISTINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "15200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

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

Verify at the official NPI Registry.