Carlie Desjardins, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

17324 Issued in NC

Practice address

10102 S Main St Ste S
Archdale, NC 27263-3183

Phone

(336) 307-3015

Fax

(336) 307-3004

NPI assigned

Aug 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Physicians and Associates PAGroup PAC ID 0244134468, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1457436982

  NC

  Medicare reassignment Care Compare group NPD
• Physical Therapy and Hand Specialists, LLC

  • Physical Therapist
  • Greensboro, NC
  • NPI 1518382357

  NC, Physical Therapist

  Medicare reassignment NPD
• Proptnc,LLC

  • Physical Therapist
  • Siler City, NC
  • NPI 1093013351

  NC, Physical Therapist

  Medicare reassignment NPD
• Eagle Physicians and Associates PA

  • Ambulatory Surgical Clinic/Center
  • Greensboro, NC
  • NPI 1396852570
  Care Compare group
• Eagle Physicians and Associates PA

  • Sleep Medicine (Internal Medicine) Physician
  • Greensboro, NC
  • NPI 1609070648
  Care Compare group
• Eagle Physicians and Associates PA

  • Physical Therapist
  • Greensboro, NC
  • NPI 1790491751
  NPD
• Physical Therapy and Hand Specialist, LLC

  • Physical Therapy Clinic/Center
  • Reidsville, NC
  • NPI 1205251964
  NPD
• Carolina Drug of Randolph County LLC

  • Community/Retail Pharmacy
  • Archdale, NC
  • NPI 1508190430
  NPD (past)
• Eagle Physicians and Associates PA

  • Primary Care Clinic/Center
  • Greensboro, NC
  • NPI 1184665499
  NPD (past)
• Keystone Rehabilitation Systems Inc

  • Rehabilitation Clinic/Center
  • Butler, PA
  • NPI 1346285251
  NPD (past)

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1699290221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10102 S MAIN ST STE S",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272633183",
            "telephone_number": "336-307-3015",
            "fax_number": "336-307-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10102 S MAIN ST STE S",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272633183",
            "telephone_number": "336-307-3015",
            "fax_number": "336-307-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "CARLIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "17324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "P17324",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Lane Davis, RPH
• Tar Davis
• Daymark Recovery Services Inc
• Daymark Recovery Services Inc
• Daymark Recovery Servicse Inc
• Juliana Digirolamo, DPT
• Dr. Keith T. Macdonald
• Michele Duvall, MA, CCC-SLP
• William Tyler Earnst, D.C.
• Easter Seals Ucp North Carolina & Virginia

• All providers in Archdale, NC
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.