Justin Kyle Squeo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P24013 Issued in NC

Practice address

201 N Church St Ste 110
Mooresville, NC 28115-2602

Phone

(704) 909-7808

NPI assigned

Aug 22, 2024

Last updated

Jun 3, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, NC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1629568647

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ati Holdings, LLC

  dba ATI Physical Therapy

  • Physical Therapy Clinic/Center
  • Rising Sun, MD
  • NPI 1396781050

  Physical Therapist

  Medicare reassignment NPD
• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1528683935
  NPD
• Ati Holdings, LLC

  • Durable Medical Equipment & Medical Supplies
  • King of Prussia, PA
  • NPI 1750194460

  Physical Therapist

  NPD

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1740013945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412313",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CHURCH ST STE 110",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152602",
            "telephone_number": "704-909-7808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9512 Harford Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212343127",
            "country_code": "US",
            "telephone_number": "410-882-3010",
            "fax_number": "410-882-3014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SQUEO",
        "first_name": "JUSTIN",
        "middle_name": "KYLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-22",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith A Spaventa, MOT,OTR/L
• Speak to Me Inc
• Speakability, Inc.
• Deborah O'Neil Speaks, FNP
• Spence Clinical Services, PLLC
• SSC Mooresville Operating Company LLC (Brian Center Health & Retirement - Mooresville)
• Stafford & Associates Counseling, PLLC
• Nanci Stafford, LCSW
• Kevin J Stanley, MD
• Rodney Jay Stanley, MD

• Physical Therapist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.