NPIMap

Organization Active NPI

Carolinas Rehabilitation

  • Rehabilitation Hospital
  • Charlotte, NC
National Provider Identifier
1790727550
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
H0071-C Issued in NC
Legal business name
CAROLINAS REHABILITATION
Practice address
1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone
(704) 355-4300
Fax
(704) 355-4231
NPI assigned
Jun 13, 2006
Last updated
Sep 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Authorized official

Name
Mr. Anthony Defurio
Title
Executive VP
Phone
(704) 355-2154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X H0071-C NC Primary

Addresses

Primary practice location

1100 Blythe Blvd
Charlotte, NC 28203-5814

Mailing address

PO Box 32861
Charlotte, NC 28232-2861
Phone (704) 512-6438

Other practice location 1

1025 Morehead Medical Dr Ste 250
Charlotte, NC 28204-2970
Phone (704) 355-4455

Other practice location 2

487 Lake Concord Rd NE
Concord, NC 28025-2934
Phone (704) 403-0100

Other practice location 3

427 N Wendover Rd
Charlotte, NC 28211-1064
Phone (704) 355-4300

Other practice location 4

101 E W T Harris Blvd Ste 5100
Charlotte, NC 28262-3485
Phone (704) 863-5780

Other practice location 5

275 Beatty Dr
Belmont, NC 28012-2715
Phone (704) 822-2550

Other practice location 6

10660 Park Rd Ste 3200
Charlotte, NC 28210-8420
Phone (704) 667-2500

Other identifiers 1

IdentifierTypeStateIssuer
343026MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080220000031 NC Part A Provider - Hospital 1557256351 Practice locations: Charlotte, NC; Concord, NC; Belmont, NC

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1790727550. Details of each certification follow.

Hospital certification: CCN 343026

Legal name
CAROLINAS REHABILITATION
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Jan 1, 1996
Last certification
Jan 4, 2001
Beds
150
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
Jun 26, 1943 in NC
Enrollment address
1100 Blythe Blvd
Charlotte, NC 28203-5814
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Hospital certification: CCN 342003

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CHARLOTTE INSTITUTEOF REHABILITATION
Certification status
Terminated Other: provider status change, Jan 1, 1996
Provider type (POS)
Hospital – Long-term
Participating since
Jul 1, 1966
Last certification
Apr 29, 1994
Beds
123
Ownership / control type
Hospital district or authority
Facility address
1100 Blythe Blvd
Charlotte, NC 28203

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Carolinas RehabilitationCCN 343026 · All quality measures
Ownership
Government
Certified
Jan 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1074142Carolinas Rehabilitation - Mt Holly275 Beatty Drive, Belmont, NC 28012Certificate of waiverSep 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Carolinas Rehabilitation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

101 E Wt Harris Blvd
Ste 5100
Charlotte, NC 28262
Phone (704) 863-1925

101 W W T Harris Blvd
Ste 5001
Charlotte, NC 28262
Phone (704) 863-5780

1025 Morehead Medical Dr
Ste 250
Charlotte, NC 28204
Phone (704) 355-4455

10620 Park Rd
Ste 200
Charlotte, NC 28210
Phone (704) 667-2500

427 N Wendover Rd
Charlotte, NC 28211
Phone (704) 304-0620

Ownership & related parties

All disclosed owners & managing parties 33

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Scott C Rissmiller Individual Corporate OfficerEvp & Chief Physician Executive Mar 25, 2019
Gary B Gragg Individual Corporate DirectorBoard Member Jan 1, 2020
David a Danzie Individual Corporate DirectorBoard Member Jan 1, 2020
William C Cannon Individual Corporate DirectorVice Chairman - Boc Jul 1, 2007
Angelique R Vincent-Hamacher Individual Corporate DirectorChairman - Boc Jan 1, 2014
Mark E Reed Individual Corporate DirectorBoard Member Jan 1, 2020
Brett J Denton Individual Corporate OfficerEvp & Chief Legal Officer Jan 1, 2002
Charles F Bowman Individual Corporate DirectorBoard Member Jan 1, 2020
Rodney E Ball Individual Corporate DirectorBoard Member Jan 3, 2019
W-2 Managing EmployeeAdministrator Jan 3, 2019
Adrienne S H Purdue Individual Corporate DirectorBoard Member Jan 1, 2020
Swati V Daji Individual Corporate DirectorBoard Member Jan 1, 2020
Carol a Lovin Individual Corporate OfficerEvp & Chief Integration Officer Jan 1, 2011
Kenneth D Haynes Individual Corporate OfficerPresident Feb 13, 2017
Corporate DirectorPresident Jan 1, 2023
Felicia H Allen Individual Corporate DirectorBoard Member Jan 1, 2020
Rasu Bickram Shrestha Individual Corporate OfficerEvp & Chief Strategy & Trans Off Feb 1, 2019
Amanda S Houser Individual Corporate DirectorBoard Member Jan 1, 2022
Marshall Carlson Individual Corporate DirectorBoard Member Feb 11, 2016
Rush S Dickson Individual Corporate DirectorBoard Member Jan 1, 2004
Katherine a Ketner Individual Corporate OfficerAssistant Secretary Jan 1, 2023
Robert G Larrison Individual W-2 Managing EmployeeVP Facility Executive Jan 1, 2009
Bradley Allen Clark Individual Corporate OfficerChief Financial Officer Aug 14, 2023
Nancy J Gritter Individual Corporate DirectorBoard Member Feb 3, 2017
Erin P Snyder Individual Corporate OfficerAssistant Secretary Jan 1, 2023
Hal a Levinson Individual Corporate DirectorBoard Member Feb 11, 2016
Nakessha T Lopez Individual Corporate OfficerEvp & Chief People & Culture Off Mar 18, 2024
Atrium Health Inc Organization, Charlotte, NC Corporation, Non-profit Operational/Managerial Control Oct 9, 2020
Advocate Health Inc Organization, Charlotte, NC Corporation, Non-profit Operational/Managerial Control Dec 2, 2022
Michael D Rucker Individual Corporate DirectorBoard Member Jan 1, 2013
Gracie P Coleman Individual Corporate DirectorVice Chairman & Secretary Boc Jan 1, 2007
Richard T Williams Individual Corporate DirectorBoard Member Jan 28, 2015
William T Niblock Individual Corporate DirectorBoard Member Jan 3, 2013
Carl J. Herring Individual Corporate DirectorBoard Member Jan 1, 2022
Victoria S Sutton Individual Corporate DirectorVice Chairman - Boc Jan 1, 2007

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 94

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 94

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

Affiliated clinicians 214

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 214

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1790727550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32861",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282322861",
            "telephone_number": "704-512-6438",
            "fax_number": "704-512-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035814",
            "telephone_number": "704-355-4300",
            "fax_number": "704-355-4231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Morehead Medical Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042970",
            "country_code": "US",
            "telephone_number": "704-355-4455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "487 Lake Concord Rd NE",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252934",
            "country_code": "US",
            "telephone_number": "704-403-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "427 N Wendover Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111064",
            "country_code": "US",
            "telephone_number": "704-355-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E W T Harris Blvd Ste 5100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-5780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "275 Beatty Dr",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "NC",
            "postal_code": "280122715",
            "country_code": "US",
            "telephone_number": "704-822-2550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10660 Park Rd Ste 3200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108420",
            "country_code": "US",
            "telephone_number": "704-667-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAROLINAS REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "DEFURIO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "704-355-2154",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NC",
            "license": "H0071-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343026",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.