Charlotte Physical Therapy & Wellness Center, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

CHARLOTTE PHYSICAL THERAPY & WELLNESS CENTER, LLC

Practice address

236-A Lephillip Court
Concord, NC 28025-1917

Phone

(704) 707-4282

Fax

(704) 795-4389

NPI assigned

Feb 19, 2020

Last updated

Feb 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Gorman

Title

Owner

Phone

(704) 707-4282

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1639702574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236-A LEPHILLIP COURT",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251917",
            "telephone_number": "704-707-4282",
            "fax_number": "704-795-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236-A LEPHILLIP COURT",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251917",
            "telephone_number": "704-707-4282",
            "fax_number": "704-795-4389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6604 Roberta Rd",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280759532",
            "country_code": "US",
            "telephone_number": "704-455-1172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHARLOTTE PHYSICAL THERAPY & WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-707-4282"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TBD",
            "affiliation": "N",
            "address_1": "236-A LePhillip Court",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280251917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Concord, NC
• Providers in Concord, 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 Feb 19, 2020; 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.