Mooresville Sports & Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MOORESVILLE SPORTS & PHYSICAL THERAPY, LLC

Practice address

478 Williamson Rd Ste E
Mooresville, NC 28117-9109

Phone

(704) 696-8223

Fax

(704) 696-8231

NPI assigned

Jul 12, 2021

Organization subpart

No

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

Authorized official

Name

Edward Heller, MSPT, ATC, CMTPTNPI 1679500839

Title

Owner/Physical Therapist

Phone

(704) 719-7348

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward J. Heller, PT

  • Physical Therapist
  • Mooresville, NC
  • NPI 1679500839
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1700458650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17217 ROYAL COURT DR",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367843",
            "telephone_number": "704-719-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 WILLIAMSON RD STE E",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179109",
            "telephone_number": "704-696-8223",
            "fax_number": "704-696-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORESVILLE SPORTS & PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "704-719-7348",
        "authorized_official_credential": "MSPT, ATC, CMTPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mooresville PPM LLC
• Mooresville PPM LLC
• Mooresville PPM, LLC
• Mooresville Rescue Squad
• Mooresville Senior Living, LLC
• Mooresville Surgical Associates
• Ana Paula Mora
• Amanda Cristina Moraes Aube
• Julie Morais, PHARM.D.
• Daima Morales, APRN

• Physical Therapy Clinic/Center in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Physical Therapy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.