Individual provider Active NPI

Kathleen Anna Lawrence, PT

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1750530580
Registry record updated Mar 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8159 Issued in NC
Practice address
3800 Shamrock Rd
Charlotte, NC 28215
Phone
(704) 532-5364
NPI assigned
Sep 17, 2008
Last updated
Mar 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2025

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 10622 SC
Physical Therapist 225100000X 8159 NC Primary

Addresses

Primary practice location

3800 Shamrock Rd
Charlotte, NC 28215

Mailing address

14417 Adair Manor CT,
Charlotte, NC 28277
Phone (704) 641-6610

Other names 1

  • Kathleen Anna Jung Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250204002334 NC Practitioner - Physical Therapist in Private Practice 1850617481 Reassigns benefits to 2 organizations
I20250206000621 SC Practitioner - Physical Therapist in Private Practice 1850617481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Wisconsin School of Medicine, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Reinvent Health Inc.Group PAC ID 2264964477, 38 clinicians
Prava PCGroup PAC ID 9931620432, 9 clinicians

Practice addresses (Care Compare)

Charlotte, NC 28211
Phone (877) 472-2261

128 S Tryon St
Suite 1920
Charlotte, NC 28202-5001
Phone (877) 472-2261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8159NCMDMental Health Counselor
10622SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Reinvent Health Inc Physical Therapist CurrentSince Jan 3, 2025 Accepting new patients
Prava PC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients

Locations

555 S Mangum St
Ste 100
Durham, NC 27701
Phone (323) 545-3659

900 Trail Ridge Rd
Fl 1
Aiken, SC 29803
Phone (803) 902-6615

900 Trail Ridge Rd
Ste 101
Aiken, SC 29803
Phone (405) 821-6648

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742083200000",
    "number": "1750530580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14417 ADAIR MANOR CT,",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-641-6610",
            "fax_number": "610-335-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SHAMROCK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28215",
            "telephone_number": "704-532-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "KATHLEEN",
        "middle_name": "ANNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2025-03-16",
        "certification_date": "2025-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10622",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "JUNG",
            "middle_name": "ANNA",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.