Active NPI
Irene Tellez
- Physical Therapist
- Charlotte, NC
National Provider Identifier
1770323966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- CP042483T
- Practice address
- 5215 Randolph Rd
Charlotte, NC 28211-5160 - Phone
- (980) 999-4595
- NPI assigned
- May 28, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P13250 | NC | |
| Physical Therapist | 225100000X | CP042483T | VA | Primary |
Addresses
Primary practice location
5215 Randolph Rd
Charlotte, NC 28211-5160
Mailing address
2726 Heidleburg LN
Charlotte, NC 28210-7665
Phone (704) 975-8578
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P13250 | NC | MD | Physical Therapist |
| CP042483T | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740960000000",
"number": "1770323966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2726 HEIDLEBURG LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282107665",
"telephone_number": "704-975-8578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5215 RANDOLPH RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282115160",
"telephone_number": "980-999-4595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLEZ",
"first_name": "IRENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-28",
"last_updated": "2025-03-03",
"certification_date": "2025-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P13250",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "VA",
"license": "CP042483T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.