Active NPI
Lillington Physical Therapy
- Physical Therapist
- Lillington, NC
National Provider Identifier
1730463035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6118
- Legal business name
- LILLINGTON PHYSICAL THERAPY
- Practice address
- 55 Bain Street
Suite 101
Lillington, NC 27546-9236 - Phone
- (910) 814-5885
- Fax
- (910) 814-8558
- NPI assigned
- Oct 5, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kimberly Dawn Leaird, PT
- Title
- President
- Phone
- (321) 698-6819
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6118 | NC | Primary |
Addresses
Primary practice location
55 Bain Street
Suite 101
Lillington, NC 27546-9236
Mailing address
144 Adcock Rd
Lillington, NC 27546-9236
Phone (910) 814-5885
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12012313 | Other | NC | CAQH |
| 1730463035 | Other | NC | NPI |
National Provider Directory
National Provider DirectoryLocations
55 Bain St
#101
Lillington, NC 27546
Phone (910) 814-5885
55 Bain St
Ste 101
Lillington, NC 27546
Phone (910) 814-5885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1323129600000",
"number": "1730463035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 ADCOCK RD",
"city": "LILLINGTON",
"state": "NC",
"postal_code": "275469236",
"telephone_number": "910-814-5885",
"fax_number": "910-814-8558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 BAIN STREET",
"address_2": "SUITE 101",
"city": "LILLINGTON",
"state": "NC",
"postal_code": "275469236",
"telephone_number": "910-814-5885",
"fax_number": "910-814-8558"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LILLINGTON PHYSICAL THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2011-10-05",
"last_updated": "2011-12-06",
"status": "A",
"authorized_official_last_name": "LEAIRD",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_middle_name": "DAWN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "321-698-6819",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "NC",
"license": "6118",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12012313",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1730463035",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lillington, NC
- Lillington Family Medical Center
- Lillington Family Medical Center, PA
- Lillington Medical Services, LLC (Cape Fear Valley Primary Care-Lillington)
- Lillington Operations, LLC (Green Leaf Care Center)
- Lillington Operator LLC (Lillington Health and Rehabilitation Center)
- LJ Medicana Transportation LLC
- Ashley Nichole Long, FNP
- Kimberly Joanne Lusk, AGNP-C
- Mahogany Place PLLC
- Larry Blaine Mahood II, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.