Marcial Nelson Fidis, LPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4633 Issued in NC

Practice address

101 Hospital Dr
Columbus, NC 28722-6418

Phone

(828) 894-8419

NPI assigned

May 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Enrolled in NC, SC, WV3 enrollments

Enrollment records 3

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Broad River RehabilitationGroup PAC ID 3375801350, 210 clinicians

Practice addresses (Care Compare)

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.

• Broad River Rehabilitation

  dba Broad River Rehab

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1902317589

  SC, WV

  Medicare reassignment Care Compare group
• Integrated Senior Care PC

  dba Integrated Senior Care

  • Geriatric Medicine (Family Medicine) Physician
  • Saint Louis, MO
  • NPI 1891689790
  NPD
• Rehabilitation Concepts

  • Physical Therapist
  • Clyde, NC
  • NPI 1346269503
  NPD (past)

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659582906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BRIARBROOK RD",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287113703",
            "telephone_number": "828-669-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL DR",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287226418",
            "telephone_number": "828-894-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDIS",
        "first_name": "MARCIAL",
        "middle_name": "NELSON",
        "name_prefix": "Mr.",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "4633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Preservation Services of North Carolina, LLC (Clarvida)
• Family Preservation Services of North Carolina, LLC (Clarvida)
• Family Preservation Services of North Carolina, LLC (Clarvida)
• Susan A Farwell, PHYSICIAN ASSISTANT
• Jennifer Diane Ferrell, LCMHC
• Cynthia S Finch, PT
• Jennifer Fisher, LMT
• Fletcher Hospital Inc (Adventhealth Pain Medicine Columbus)
• Fletcher Hospital Inc
• Fletcher Hospital Inc

• Physical Therapist in Columbus, NC
• Providers in Columbus, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.