Individual provider Active NPI

Carmen Larae McDonald, P.T.

  • Physical Therapist
  • Greenville, NC
National Provider Identifier
1811987498
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2952 Issued in OK
Practice address
2430 Charles Blvd
Greenville, NC 27858-5924
Phone
(252) 215-9119
Fax
(252) 215-9121
NPI assigned
Oct 25, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2952 OK Primary

Addresses

Primary practice location

2430 Charles Blvd
Greenville, NC 27858-5924

Mailing address

PO Box 4065
Greenville, NC 27836-2065
Phone (252) 215-9119

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131114000852 NC Practitioner - Physical Therapist in Private Practice 1759336761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Physical Therapy and Associates IncGroup PAC ID 6406932888, 3 clinicians

Practice addresses (Care Compare)

2430 Charles Blvd
Greenville, NC 27858-5924
Phone (252) 215-9119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2952OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Physical Therapy and Associates, Inc Physical Therapist CurrentSince Sep 9, 2013 Accepting new patients
Socal Rehab Associates Inc Physical Therapist CurrentSince Aug 20, 2010 Accepting new patients
H2 Health Oklahoma Outpatient Clinics LLC Physical Therapist PastSince Jun 1, 2021 Accepting new patients

Locations

3908 10th St
Riverside, CA 92501
Phone (909) 274-7744

2430 Charles Blvd
Greenville, NC 27858
Phone (252) 215-9119

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1811987498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4065",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278362065",
            "telephone_number": "252-215-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 CHARLES BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585924",
            "telephone_number": "252-215-9119",
            "fax_number": "252-215-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "CARMEN",
        "middle_name": "LARAE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "2952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.