Carolina Physical Rehabilitation Services, Inc.

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

7131 Issued in NC

Legal business name

CAROLINA PHYSICAL REHABILITATION SERVICES, INC.

Practice address

507 Jones St
Marshville, NC 28103-1231

Phone

(704) 624-0346

Fax

(704) 624-0356

NPI assigned

Jun 20, 2006

Last updated

Oct 23, 2008By 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

Mrs. Shade F Bada

Title

Practice Administrator

Phone

(704) 624-0346

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Taiwo O Bada

  • Physical Therapist
  • Marshville, NC
  • NPI 1700821394
  Medicare reassignment NPD
• Erin L Campbell, OTRL

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1124064217
  NPD (past)
• Jahzara Isra Ali-Dey, MOTL

  • Occupational Therapist
  • Albemarle, NC
  • NPI 1033155122
  NPD (past)
• Karan Bobby Johar, D.P.T

  • Geriatric Physical Therapist
  • Charlotte, NC
  • NPI 1003118977
  NPD (past)
• Rebecca Jones

  • Occupational Therapist
  • Wadesboro, NC
  • NPI 1760752968
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1699711507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 JONES ST",
            "address_2": "PO BOX 237",
            "city": "MARSHVILLE",
            "state": "NC",
            "postal_code": "281031231",
            "telephone_number": "704-624-0346",
            "fax_number": "704-624-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 JONES ST",
            "city": "MARSHVILLE",
            "state": "NC",
            "postal_code": "281031231",
            "telephone_number": "704-624-0346",
            "fax_number": "704-624-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PHYSICAL REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "BADA",
        "authorized_official_first_name": "SHADE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "704-624-0346",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NC",
            "license": "7131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211726",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenton Bundrick, DDS, PLLC (Marshville Dental)
• Wesley Buie
• Brenton Bundrick, D.D.S.
• Charlitta Estie Burruss, SOCIAL WORKER
• Carolina Behavioral Consulting LLC. (Carolina Behavioral)
• Nicole Craven Clark, OTR/L
• Community Medical, P.a.
• Michael Covert
• Hannah Blair Davis, DMD
• Adjara Latifa Dembele

• Rehabilitation Practitioner in Marshville, NC
• Providers in Marshville, NC by specialty
• Rehabilitation Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.

Verify at the official NPI Registry.