Individual provider Active NPI

John Buczkowski

  • Physical Therapist
  • Gastonia, NC
National Provider Identifier
1760873129
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P15453 Issued in NC
Practice address
801 Cox Rd
Gastonia, NC 28054-3453
Phone
(704) 867-7455
NPI assigned
Feb 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P15453 NC Primary

Addresses

Primary practice location

801 Cox Rd
Gastonia, NC 28054-3453

Mailing address

257 Marshall Dr
Pittsburgh, PA 15235-4347
Phone (412) 999-0638

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220711001057 NC Practitioner - Physical Therapist in Private Practice 5991185738 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Therapy of North Carolina Inc CurrentSince May 1, 2022 Accepting new patients
Proactive Therapy of North Carolina Inc Current Accepting new patients
Proactive Therapy of North Carolina Inc CurrentSince May 1, 2022 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince May 1, 2022 Accepting new patients
Select Physical Therapy Holdings Inc Current Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince May 1, 2022 Accepting new patients

Locations

3611 Mt Holly Huntersville Rd
Ste 204
Charlotte, NC 28216
Phone (980) 256-3171

10020 Edison Square Dr NW
Ste C105
Concord, NC 28027
Phone (704) 948-5351

970 Branchview Dr NE
Ste 160
Concord, NC 28025
Phone (704) 782-1322

801 Cox Rd
Gastonia, NC 28054
Phone (704) 867-7455

2358 US Highway 70
Ste Ab
Swannanoa, NC 28778
Phone (828) 686-3375

Organizations & group practices 6

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": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1760873129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 MARSHALL DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152354347",
            "telephone_number": "412-999-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 COX RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543453",
            "telephone_number": "704-867-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCZKOWSKI",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P15453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.