NPIMap

Organization Active NPI

Physical Therapy of North Carolina, LLC

  • Physical Therapist
  • Durham, NC
National Provider Identifier
1760453989
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL THERAPY OF NORTH CAROLINA, LLC
Practice address
4214 N. Roxboro Street
Suite 100
Durham, NC 27704-2122
Phone
(919) 479-9001
Fax
(919) 479-9003
NPI assigned
Jan 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Authorized official

Name
Barbara Ellen Roeber, PTNPI 1073571980
Title
PT/Owner
Phone
(919) 479-9001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4214 N. Roxboro Street
Suite 100
Durham, NC 27704-2122

Mailing address

4214 N. Roxboro Street
Suite 100
Durham, NC 27704-2122
Phone (919) 479-9001

Other identifiers 1

IdentifierTypeStateIssuer
014A7OtherNCBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040802001321 NC Part B Supplier - Clinic/Group Practice 4880665157 Receives reassigned benefits from 10 practitioners
Practice locations: Durham, NC

National Provider Directory

National Provider Directory

Locations

4214 N Roxboro St
Ste 100
Durham, NC 27704
Phone (919) 479-9001

2609 N Duke St
Ste 305
Durham, NC 27704
Phone (919) 220-9001

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1760453989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 N. ROXBORO STREET",
            "address_2": "SUITE 100",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042122",
            "telephone_number": "919-479-9001",
            "fax_number": "919-479-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 N. ROXBORO STREET",
            "address_2": "SUITE 100",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042122",
            "telephone_number": "919-479-9001",
            "fax_number": "919-479-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY OF NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "ROEBER",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "919-479-9001",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "014A7",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.