NPIMap

Organization Active NPI

Physical Therapy of the Triad, Corp.

  • Physical Therapist
  • High Point, NC
National Provider Identifier
1790096485
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8012 Issued in NC
Legal business name
PHYSICAL THERAPY OF THE TRIAD, CORP.
Practice address
4628 River Valley Rd
High Point, NC 27265-9295
Phone
(336) 391-7892
Fax
(336) 665-8446
NPI assigned
Jun 28, 2010
Last updated
Oct 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Authorized official

Name
Mr. Jeffrey Eugene Leatherman, PT
Title
President
Phone
(336) 391-7892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8012 NC Primary

Addresses

Primary practice location

4628 River Valley Rd
High Point, NC 27265-9295

Mailing address

4628 River Valley Rd
High Point, NC 27265-9295
Phone (336) 391-7892

National Provider Directory

National Provider Directory

Locations

500 Americhase Dr
Ste K
Greensboro, NC 27409
Phone (336) 665-8445

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1790096485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4628 RIVER VALLEY RD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659295",
            "telephone_number": "336-391-7892",
            "fax_number": "336-665-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4628 RIVER VALLEY RD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659295",
            "telephone_number": "336-391-7892",
            "fax_number": "336-665-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY OF THE TRIAD, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-28",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "LEATHERMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-391-7892",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.