NPIMap

Organization Active NPI

Innovative Therapy Services LLC

Doing business as Innovative Therapy & Wellness

  • Physical Therapist
  • New Bern, NC
National Provider Identifier
1891026803
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
INNOVATIVE THERAPY SERVICES LLC
Doing business as
Innovative Therapy & Wellness
Practice address
1030 Broad Creek Rd
New Bern, NC 28560-7102
Phone
(252) 633-6335
Fax
(252) 635-1130
NPI assigned
Jan 15, 2010
Last updated
Jan 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Authorized official

Name
Tracy P Ingram
Title
Operator
Phone
(252) 633-6335

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

1030 Broad Creek Rd
New Bern, NC 28560-7102

Mailing address

1030 Broad Creek Rd
New Bern, NC 28560-7102
Phone (252) 633-6335

Other names 1

  • INNOVATIVE THERAPY & WELLNESS Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263513600000",
    "number": "1891026803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 BROAD CREEK RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285607102",
            "telephone_number": "252-633-6335",
            "fax_number": "252-635-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 BROAD CREEK RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285607102",
            "telephone_number": "252-633-6335",
            "fax_number": "252-635-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-15",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "252-633-6335"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INNOVATIVE THERAPY & WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.