NPIMap

Organization Active NPI

Carolina Pediatric Rehabilitation Services, Inc.

  • Physical Therapist
  • Wilmington, NC
National Provider Identifier
1821294299
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4511 Issued in NC
Legal business name
CAROLINA PEDIATRIC REHABILITATION SERVICES, INC.
Practice address
405 S 2ND St
Wilmington, NC 28401-5001
Phone
(910) 520-0202
Fax
(910) 254-3566
NPI assigned
Jun 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Authorized official

Name
Kathleen M. Kane-Maxwell, PHYSICAL THERAPISTNPI 1225092216
Title
President
Phone
(910) 520-0202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 4511 NC Primary

Addresses

Primary practice location

405 S 2ND St
Wilmington, NC 28401-5001

Mailing address

405 S 2ND St
Wilmington, NC 28401-5001
Phone (910) 520-0202

Other identifiers 1

IdentifierTypeStateIssuer
7210741MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1821294299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S 2ND ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284015001",
            "telephone_number": "910-520-0202",
            "fax_number": "910-254-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S 2ND ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284015001",
            "telephone_number": "910-520-0202",
            "fax_number": "910-254-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PEDIATRIC REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "KANE-MAXWELL",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-520-0202",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "4511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7210741",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.