Active NPI
Ayrsley Town Rehabilitation, LLC
- Physical Therapist
- Charlotte, NC
National Provider Identifier
1679722201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1235270
- Legal business name
- AYRSLEY TOWN REHABILITATION, LLC
- Practice address
- 2064A Ayrsley Town Blvd
Charlotte, NC 28273-3577 - Phone
- (980) 939-1580
- Fax
- (980) 939-1128
- NPI assigned
- Sep 18, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alex Gomez, DPT
- Title
- President
- Phone
- (980) 939-1580
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1235270 | NC | Primary |
Addresses
Primary practice location
2064A Ayrsley Town Blvd
Charlotte, NC 28273-3577
Mailing address
2064A Ayrsley Town Blvd
Charlotte, NC 28273-3577
Phone (980) 939-1580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090127000556 | NC | Part B Supplier - Clinic/Group Practice | 0143384792 |
Receives reassigned benefits from 5 practitioners Practice locations: Pineville, NC; Gastonia, NC; Charlotte, NC |
National Provider Directory
National Provider DirectoryLocations
3826 S New Hope Rd
Ste 8
Gastonia, NC 28056
Phone (809) 939-1580
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Mint Hill, NC
- NPI 1720254220
NC, Physical Therapist
-
- Physical Therapist
- Charlotte, NC
- NPI 1841429651
-
- Physical Therapist
- Charlotte, NC
- NPI 1336426931
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221696000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687824000000",
"number": "1679722201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2064A AYRSLEY TOWN BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282733577",
"telephone_number": "980-939-1580",
"fax_number": "980-939-1128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2064A AYRSLEY TOWN BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282733577",
"telephone_number": "980-939-1580",
"fax_number": "980-939-1128"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AYRSLEY TOWN REHABILITATION, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-18",
"last_updated": "2023-06-27",
"certification_date": "2023-06-27",
"status": "A",
"authorized_official_last_name": "GOMEZ",
"authorized_official_first_name": "ALEX",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "980-939-1580",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "NC",
"license": "1235270",
"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 Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.