Organization Active NPI

Shoreline Physical Therapy, LLC

  • Physical Therapist
  • Wilmington, NC
National Provider Identifier
1851685010
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6039 Issued in NC
Legal business name
SHORELINE PHYSICAL THERAPY, LLC
Practice address
1717 Shipyard Blvd
Suite 320
Wilmington, NC 28403-8023
Phone
(910) 791-0396
NPI assigned
Jun 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Authorized official

Name
Jerome Isear, PTNPI 1548243074
Title
Therapist/Co-Owner
Phone
(910) 791-0396

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 6039 NC Primary

Addresses

Primary practice location

1717 Shipyard Blvd
Suite 320
Wilmington, NC 28403-8023

Mailing address

1717 Shipyard Blvd
Suite 320
Wilmington, NC 28403-8023
Phone (910) 791-0396

Other names 1

  • Shoreline Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110919000014 NC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4688845985 Receives reassigned benefits from 4 practitioners
Practice locations: Wilmington, NC

National Provider Directory

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1851685010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 SHIPYARD BLVD",
            "address_2": "SUITE 320",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038023",
            "telephone_number": "910-791-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SHIPYARD BLVD",
            "address_2": "SUITE 320",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038023",
            "telephone_number": "910-791-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "ISEAR",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "THERAPIST/CO-OWNER",
        "authorized_official_telephone_number": "910-791-0396",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "6039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoreline Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 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.