NPIMap

Organization Active NPI

Carolinas Rehabilitation

  • Group Psychotherapy Psychologist
  • Charlotte, NC
National Provider Identifier
1821112665
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
Legal business name
CAROLINAS REHABILITATION
Practice address
1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone
(704) 355-4370
NPI assigned
Mar 19, 2007
Last updated
Dec 3, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS REHABILITATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Mr. William Alex Hopkins
Title
Director of Finance
Phone
(704) 512-6429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X NU Primary

Addresses

Primary practice location

1100 Blythe Blvd
Charlotte, NC 28203-5814

Mailing address

1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone (704) 355-4370

Other names 1

  • CIR Psychology Practice Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419000763 NC Part B Supplier - Clinic/Group Practice 1557256351 Receives reassigned benefits from 7 practitioners
Practice locations: Charlotte, NC; Concord, NC

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

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

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1821112665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035814",
            "telephone_number": "704-355-4370"
        },
        {
            "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": "704-355-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS REHABILITATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS REHABILITATION",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "HOPKINS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ALEX",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "704-512-6429",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CIR Psychology Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.