Individual provider Active NPI

Robert Everhart III, PTA

  • Physical Therapy Assistant
  • Lenoir, NC
National Provider Identifier
1801569553
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A4600 Issued in NC
Practice address
1450 Shaire Center Dr
Lenoir, NC 28645-7565
Phone
(828) 728-6500
NPI assigned
Jul 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A4600 NC Primary

Addresses

Primary practice location

1450 Shaire Center Dr
Lenoir, NC 28645-7565

Mailing address

2784 Blue Creek Rd
Lenoir, NC 28645-7617
Phone (828) 640-3303

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

LicenseStateTypeSpecialty
A4600NCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1801569553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2784 BLUE CREEK RD",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286457617",
            "telephone_number": "828-640-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SHAIRE CENTER DR",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286457565",
            "telephone_number": "828-728-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERHART",
        "first_name": "ROBERT",
        "name_suffix": "III",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A4600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.