Individual provider Active NPI

Eileen Mittmann, PT

  • Physical Therapist
  • Denver, NC
National Provider Identifier
1760183685
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21728 Issued in NC
Practice address
3900 Wexford LN
Denver, NC 28037-7900
Phone
(704) 489-2633
NPI assigned
Mar 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 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 P21728 NC Primary
Physical Therapist 225100000X P21728 WI

Addresses

Primary practice location

3900 Wexford LN
Denver, NC 28037-7900

Mailing address

6605 Redbridge TRL
Charlotte, NC 28269-8983
Phone (920) 838-3332

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230503001839 NC Practitioner - Physical Therapist in Private Practice 9739544362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

3150 Burke Mill Rd
RM 200
Winston Salem, NC 27103-6431
Phone (336) 397-4200

4025 N Sharon Amity Rd
C/O Parc at Sharon Amity
Charlotte, NC 28205-4975
Phone (704) 869-2721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P21728NCMDPhysical Therapist
P21728WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC Physical Therapist CurrentSince Mar 16, 2023 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Mar 16, 2023 Accepting new patients

Locations

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1760183685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6605 REDBRIDGE TRL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282698983",
            "telephone_number": "920-838-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 WEXFORD LN",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280377900",
            "telephone_number": "704-489-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTMANN",
        "first_name": "EILEEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21728",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "P21728",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.