Organization Active NPI

Fight Back Performance and Recovery, LLC

  • Multi-Specialty Clinic/Center
  • Charlotte, NC
National Provider Identifier
1851867394
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
FIGHT BACK PERFORMANCE AND RECOVERY, LLC
Practice address
1200 E Morehead St Ste 190
Charlotte, NC 28204-2946
Phone
(919) 619-8231
NPI assigned
Oct 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Authorized official

Name
Dr. Katherine Alden Edwards, DPTNPI 1265818744
Title
Co-Owner, Physical Therapist
Phone
(980) 209-0656

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

1200 E Morehead St Ste 190
Charlotte, NC 28204-2946

Mailing address

1200 E Morehead St Ste 190
Charlotte, NC 28204-2946
Phone (980) 209-0656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190222001176 NC Part B Supplier - Clinic/Group Practice 0446599294 Receives reassigned benefits from 3 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

1200 E Morehead St
Ste 190
Charlotte, NC 28204
Phone (704) 301-8747

Practitioners & affiliated clinicians

Practitioners 6

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": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1851867394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E MOREHEAD ST STE 190",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042946",
            "telephone_number": "980-209-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MOREHEAD ST STE 190",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042946",
            "telephone_number": "919-619-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIGHT BACK PERFORMANCE AND RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2019-05-01",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ALDEN",
        "authorized_official_title_or_position": "CO-OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "980-209-0656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 1, 2019; 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.