Individual provider Active NPI

Tait Lawrence, DPT

  • Physical Therapist
  • Wilmington, NC
National Provider Identifier
1780251371
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P22806 Issued in NC
Practice address
140 Hays LN Ste 110
Wilmington, NC 28411-3102
Phone
(910) 302-3280
Fax
(910) 213-3571
NPI assigned
Jun 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 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 10677 SC
Physical Therapist 225100000X P22806 NC Primary

Addresses

Primary practice location

140 Hays LN Ste 110
Wilmington, NC 28411-3102

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Other practice location 1

1525 Chapin Road
Chapin, SC 29036-2903
Phone (803) 924-8405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211004003185 SC Practitioner - Physical Therapist in Private Practice 5294133328 Reassigns benefits to 1 organization
I20240108004587 NC Practitioner - Physical Therapist in Private Practice 5294133328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activcare Physical Therapy, LLCGroup PAC ID 8628027471, 126 clinicians

Practice addresses (Care Compare)

140 Hays LN
Suite 110
Wilmington, NC 28411-3102
Phone (910) 302-3280

Merit-based Incentive Payment System (MIPS)

Final score
86.48 of 100Reported as group
Quality
86.95
Improvement activities
40
Cost
72.33

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
85.21
Promoting interoperability
99
Improvement activities
40
Cost
77.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P22806NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Nov 8, 2023 Accepting new patients
Chapin Rehabilitation Clinic, Inc. CurrentSince May 17, 2021 Accepting new patients
Chapin Physical Therapy LLC Physical Therapist PastSince May 17, 2021 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042

140 Hays Ln
Ste 110
Wilmington, NC 28411
Phone (910) 302-3280

Interoperability endpoints

  • Direct secure messaging: tait.lawrence.p12@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

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": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1780251371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HAYS LN STE 110",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284113102",
            "telephone_number": "910-302-3280",
            "fax_number": "910-213-3571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Chapin Road",
            "address_purpose": "LOCATION",
            "city": "Chapin",
            "state": "SC",
            "postal_code": "290362903",
            "country_code": "US",
            "telephone_number": "803-924-8405",
            "fax_number": "803-345-3018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "TAIT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-10",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10677",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.