Back to Independence Rehab LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

BACK TO INDEPENDENCE REHAB LLC

Practice address

4801 Chastain Ave Ste 194
Charlotte, NC 28217-2136

Phone

(980) 277-7105

NPI assigned

Oct 24, 2023

Organization subpart

No

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

Authorized official

Name

Darci Pernoud, OTNPI 1144865734

Title

Owner

Phone

(980) 277-7105

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Darci Pernoud, OT

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1144865734
  NPD Authorized official

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1700658754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 CHASTAIN AVE STE 194",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 CHASTAIN AVE STE 194",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172136",
            "telephone_number": "980-277-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO INDEPENDENCE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "PERNOUD",
        "authorized_official_first_name": "DARCI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-277-7105",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.