Organization Active NPI

Kernersville Rehab Specialists LLC

  • Physical Therapist
  • Kernersville, NC
National Provider Identifier
1831157833
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8652 Issued in NC
Legal business name
KERNERSVILLE REHAB SPECIALISTS LLC
Practice address
1027 E Mountain St # 101
Kernersville, NC 27284-7902
Phone
(336) 996-4980
Fax
(336) 996-3521
NPI assigned
May 2, 2006
Last updated
Dec 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Authorized official

Name
Terry Jones
Title
Practice Administrator
Phone
(336) 996-4980

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8652 NC Primary
Occupational Therapist 225X00000X 5073 NC

Addresses

Primary practice location

1027 E Mountain St # 101
Kernersville, NC 27284-7902

Mailing address

1027 E Mountain St # 101
Kernersville, NC 27284-7902
Phone (336) 996-4980

Other identifiers 1

IdentifierTypeStateIssuer
7211541MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040825000774 NC Part B Supplier - Clinic/Group Practice 2264406115 Receives reassigned benefits from 4 practitioners
Practice locations: Kernersville, NC

National Provider Directory

National Provider Directory

Locations

1027 E Mountain St
Ste 101
Kernersville, NC 27284
Phone (336) 996-4980

1031 E Mountain St
Ste 101
Kernersville, NC 27284
Phone (336) 996-4980

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": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764633600000",
    "number": "1831157833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E MOUNTAIN ST # 101",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847902",
            "telephone_number": "336-996-4980",
            "fax_number": "336-996-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 E MOUNTAIN ST # 101",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847902",
            "telephone_number": "336-996-4980",
            "fax_number": "336-996-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERNERSVILLE REHAB SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "336-996-4980"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8652",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "5073",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211541",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.