Providence Physical Medicine PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2006-01409 Issued in NC

Legal business name

PROVIDENCE PHYSICAL MEDICINE PC

Practice address

6911 Shannon Willow Rd
Ste 500
Charlotte, NC 28226-1346

Phone

(704) 800-7414

NPI assigned

Jul 11, 2016

Organization subpart

No

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

Authorized official

Name

Rachel Hyser

Title

Office Manager

Phone

(704) 620-8857

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1891147237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 SHANNON WILLOW RD",
            "address_2": "STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282261346",
            "telephone_number": "704-800-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 SHANNON WILLOW RD",
            "address_2": "STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282261346",
            "telephone_number": "704-800-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PHYSICAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "HYSER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-620-8857"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "2006-01409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Counseling & Training, Inc.
• Providence Eye and Laser Specialists, PC
• Providence Family Psychiatry
• Providence Health Center
• Providence Pediatrics
• Providence Psychiatric & Behavioral Health Services, Inc
• Providence Transportation Solutions, LLC
• Providence View Counseling & Play Therapy, PLLC
• Providential Care Services LLC
• Provisions Counseling Services

• Physical Medicine & Rehabilitation Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.