Carolinas Rehabilitation
Organization Active NPI Rehabilitation Hospital · Charlotte, NC
NPI 1790727550 · NPPES record last updated Sep 26, 2025
Key facts
- NPI
- 1790727550
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Hospital 283X00000X
- License
- H0071-C (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
- Organization subpart
- No
Authorized official
- Name
- Mr. Anthony Defurio
- Title
- Executive VP
- Phone
- (704) 355-2154
Owners & managing parties with NPI records 1
-
Nancy Gritter, MD
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 3
Facilities with the same owner 94
Practitioners 36
-
Brian W Ablitz, PSY.D., ABPP
-
Kathryn B Crump, PSYD.
-
Shelley Leigh Leininger, PH.D.
-
Marlena Nicole Matusewicz, PSY.D.
-
John T Beetar, PH.D
-
Marco A Caiazza, PT
-
Susan B Crawley, PHD
-
Christa Carol Cullen, OTR/L
-
Mary F Draize, PT
-
Macy Dunnagan, M.S., CCC-SLP
-
Adele H Haber, PH.D., ABPP-CN
-
Eileen M Keogh, PT
-
Jennifer M. Kinser, CRNA
-
Eileen Q. Parker, CRNA
Affiliated clinicians 214
-
Brian W Ablitz, PSY.D., ABPP
-
Nabil Ahmad, MD
-
Kristen Ann Aleccia, PA-C
-
James Chester Alexander, M.D.
-
Maram Alkhatib, MD
-
Vittorio Paolo Antonacci, M.D.
-
Shubekchha Aryal, MD
-
Iyad Hanna Asaad, MD
-
Jessica Atkinson, NP
-
Richard Tae Bach, MD
-
Ross Joseph Bellavia, M.D.
-
Erika L. Bono, MD
-
Robert Calvin Bowen III, M.D.
Medicare Care Compare: Inpatient rehabilitation facility
- Listed as
- Carolinas Rehabilitation
- Ownership
- Government
- Certified
- Jan 1, 1996
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D1074142 | Carolinas Rehabilitation - Mt Holly | Certificate of waiver | Sep 24, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
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
- Other · Non-profit
- Incorporated
- Jun 26, 1943 in NC
- Enrollment address
- 1100 Blythe Blvd
Charlotte, NC 28203-5814 - Hospital subgroups
- Rehabilitation
All disclosed owners & managing parties 33
| Name | Role | Since | Share |
|---|---|---|---|
| Scott C Rissmiller |
Corporate Officer |
Mar 25, 2019 | |
| Gary B Gragg |
Corporate Director |
Jan 1, 2020 | |
| David a Danzie |
Corporate Director |
Jan 1, 2020 | |
| William C Cannon |
Corporate Director |
Jul 1, 2007 | |
| Angelique R Vincent-Hamacher |
Corporate Director |
Jan 1, 2014 | |
| Mark E Reed |
Corporate Director |
Jan 1, 2020 | |
| Brett J Denton |
Corporate Officer |
Jan 1, 2002 | |
| Charles F Bowman |
Corporate Director |
Jan 1, 2020 | |
| Rodney E Ball |
Corporate Director |
Jan 3, 2019 | |
| W-2 Managing Employee |
Jan 3, 2019 | ||
| Adrienne S H Purdue |
Corporate Director |
Jan 1, 2020 | |
| Swati V Daji |
Corporate Director |
Jan 1, 2020 | |
| Carol a Lovin |
Corporate Officer |
Jan 1, 2011 | |
| Kenneth D Haynes |
Corporate Officer |
Feb 13, 2017 | |
| Corporate Director |
Jan 1, 2023 | ||
| Felicia H Allen |
Corporate Director |
Jan 1, 2020 | |
| Rasu Bickram Shrestha |
Corporate Officer |
Feb 1, 2019 | |
| Amanda S Houser |
Corporate Director |
Jan 1, 2022 | |
| Marshall Carlson |
Corporate Director |
Feb 11, 2016 | |
| Rush S Dickson |
Corporate Director |
Jan 1, 2004 | |
| Katherine a Ketner |
Corporate Officer |
Jan 1, 2023 | |
| Robert G Larrison |
W-2 Managing Employee |
Jan 1, 2009 | |
| Bradley Allen Clark |
Corporate Officer |
Aug 14, 2023 | |
| Nancy J Gritter |
Corporate Director |
Feb 3, 2017 | |
| Erin P Snyder |
Corporate Officer |
Jan 1, 2023 | |
| Hal a Levinson |
Corporate Director |
Feb 11, 2016 | |
| Nakessha T Lopez |
Corporate Officer |
Mar 18, 2024 | |
| Atrium Health Inc |
Operational/Managerial Control | Oct 9, 2020 | |
| Advocate Health Inc |
Operational/Managerial Control | Dec 2, 2022 | |
| Michael D Rucker |
Corporate Director |
Jan 1, 2013 | |
| Gracie P Coleman |
Corporate Director |
Jan 1, 2007 | |
| Richard T Williams |
Corporate Director |
Jan 28, 2015 | |
| William T Niblock |
Corporate Director |
Jan 3, 2013 | |
| Carl J. Herring |
Corporate Director |
Jan 1, 2022 | |
| Victoria S Sutton |
Corporate Director |
Jan 1, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080220000031 | NC | Part a Provider - Hospital | 1557256351 | Practice locations: Charlotte, NC; Concord, NC; Belmont, NC |
National Provider Directory
- Tax ID family
- Carolinas Rehabilitation
Locations
101 W W T Harris Blvd
Ste 5001
Charlotte, NC 28262
Phone (704) 863-5780
101 E Wt Harris Blvd
Ste 5100
Charlotte, NC 28262
Phone (704) 863-1925
1025 Morehead Medical Dr
Ste 250
Charlotte, NC 28204
Phone (704) 355-4455
427 N Wendover Rd
Charlotte, NC 28211
Phone (704) 304-0620
101 E Wt Harris Blvd
Ste 5001
Charlotte, NC 28262
Phone (704) 547-7319
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital | 283X00000X | H0071-C | NC | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 343026 | Medicaid | NC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Charlotte, NC
- Carolinas Physicians Network, Inc.
- Carolinas Physicians Network, Inc.
- Carolinas Professional Counseling & Consulting, PLLC
- Carolinas Psychiatric Institute, PLLC
- Carolinas Quality Family Services, LLC
- Carolinas Rehabilitation
- Carolinas Research Center
- Carolinas Skin Center PA
- Carolinas Vision Group
- Carolinas Weight Management
All providers in Charlotte, NC · Rehabilitation Hospital in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.