Individual provider Active NPI

Alexandria Anderson, DPT

  • Physical Therapist
  • Indian Trail, NC
National Provider Identifier
1730927807
Registry record updated Oct 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P23174 Issued in NC
Practice address
1001 Van Buren Ave Ste 3
Indian Trail, NC 28079-5541
Phone
(704) 628-6053
Fax
(704) 628-6702
NPI assigned
Jul 15, 2024
Last updated
Oct 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1394639 TX
Physical Therapist 225100000X P23174 NC Primary

Addresses

Primary practice location

1001 Van Buren Ave Ste 3
Indian Trail, NC 28079-5541

Mailing address

1429 Bryant St Ste a
Charlotte, NC 28208-5201
Phone (704) 919-0867

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726002152 TX Practitioner - Physical Therapist in Private Practice 3779029608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1013 W University Ave
Suite 335
Georgetown, TX 78628-5343
Phone (512) 876-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P23174NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Jul 8, 2024 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Jul 8, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

1013 W University Ave
Ste 335
Georgetown, TX 78628
Phone (512) 876-2111

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791590400000",
    "number": "1730927807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 BRYANT ST STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085201",
            "telephone_number": "704-919-0867",
            "fax_number": "704-817-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 VAN BUREN AVE STE 3",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795541",
            "telephone_number": "704-628-6053",
            "fax_number": "704-628-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALEXANDRIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2026-10-10",
        "certification_date": "2026-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1394639",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.