NPIMap

Organization Active NPI

Benchmark Physical Therapy of NC, LLC

  • Physical Therapist
  • Concord, NC
National Provider Identifier
1730624065
Registry record updated Sep 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BENCHMARK PHYSICAL THERAPY OF NC, LLC
Practice address
354 George W Liles Pkwy NW
Ste 140
Concord, NC 28027-2403
Phone
(704) 782-8036
Fax
(704) 720-7273
NPI assigned
Dec 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2017

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

Authorized official

Name
Kevin Johanneson
Title
VP Revenue Cycle
Phone
(423) 238-7217

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

354 George W Liles Pkwy NW
Ste 140
Concord, NC 28027-2403

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217

Other names 2

  • BenchMark PT - Concrod Other name
  • Benchmark PT - Concord Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250716000054 NC DME Supplier - Independently-Practicing Physical Therapist 1052609278 Practice locations: Concord, NC

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Benchmark Physical Therapy of NC LLC74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 242

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

View all 242

NPI Registry JSON

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504224000000",
    "number": "1730624065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 GEORGE W LILES PKWY NW",
            "address_2": "STE 140",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280272403",
            "telephone_number": "704-782-8036",
            "fax_number": "704-720-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENCHMARK PHYSICAL THERAPY OF NC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-22",
        "last_updated": "2017-09-01",
        "status": "A",
        "authorized_official_last_name": "JOHANNESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BenchMark PT - Concrod",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Benchmark PT - Concord",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; 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.