NPIMap

Organization Active NPI

Advanced Therapy, PLLC

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1699788109
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2957 Issued in NC
Legal business name
ADVANCED THERAPY, PLLC
Practice address
8300 Falls of Neuse Rd
Ste 104
Raleigh, NC 27615
Phone
(919) 846-9668
Fax
(919) 846-9663
NPI assigned
Aug 14, 2006
Last updated
Feb 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Mr. Brian Conly, PTNPI 1295947612
Title
Manager
Phone
(919) 846-9668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2957 NC Primary

Addresses

Primary practice location

8300 Falls of Neuse Rd
Ste 104
Raleigh, NC 27615

Mailing address

8300 Falls of Neuse Rd
Ste 104
Raleigh, NC 27615
Phone (919) 846-9668

Other identifiers 1

IdentifierTypeStateIssuer
7211368MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000788 NC Part B Supplier - Clinic/Group Practice 3375456270 Receives reassigned benefits from 12 practitioners
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory
Tax ID family
Advanced Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

414 Gallimore Dairy Rd
Ste A
Greensboro, NC 27409
Phone (336) 391-7892

8300 Falls of Neuse Rd
Ste 104
Raleigh, NC 27615
Phone (919) 426-9292

8436 Norman Estates Way
Raleigh, NC 27613

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1699788109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 FALLS OF NEUSE RD",
            "address_2": "STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27615",
            "telephone_number": "919-846-9668",
            "fax_number": "919-846-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 FALLS OF NEUSE RD",
            "address_2": "STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27615",
            "telephone_number": "919-846-9668",
            "fax_number": "919-846-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "CONLY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "919-846-9668",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "2957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211368",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.