Individual provider Active NPI

Amy Diane Mierzwa, DPT

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1669431003
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7528 Issued in NC
Practice address
7239 Pineville Matthews Rd
Suite 400
Charlotte, NC 28226-6153
Phone
(980) 224-7958
Fax
(980) 224-7973
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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 7528 NC Primary

Addresses

Primary practice location

7239 Pineville Matthews Rd
Suite 400
Charlotte, NC 28226-6153

Mailing address

7239 Pineville Matthews Rd
Suite 400
Charlotte, NC 28226-6153
Phone (980) 224-7958

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7528NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiofocus Orthopedic and Sports Therapy LLC CurrentSince Apr 4, 2013 Accepting new patients

Locations

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

7239 Pineville Matthews Rd
Ste 400
Charlotte, NC 28226
Phone (704) 246-4416

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1669431003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7239 PINEVILLE MATTHEWS RD",
            "address_2": "SUITE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282266153",
            "telephone_number": "980-224-7958",
            "fax_number": "980-224-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7239 PINEVILLE MATTHEWS RD",
            "address_2": "SUITE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282266153",
            "telephone_number": "980-224-7958",
            "fax_number": "980-224-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIERZWA",
        "first_name": "AMY",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "7528",
            "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 Feb 14, 2013; 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.