Johnny Philebaum, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P21566 Issued in NC

Practice address

110 W King St Ste 9
Kings Mountain, NC 28086-3437

Phone

(704) 739-5995

NPI assigned

Aug 19, 2022

Last updated

Aug 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Prava PCGroup PAC ID 9931620432, 9 clinicians

Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1629568647

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Prava PC

  • Physical Therapist
  • Chicago, IL
  • NPI 1841003753

  NC

  Medicare reassignment Care Compare group
• Duke University Health System, Inc.

  dba Duke University Hospital

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977

  Physical Therapist

  Medicare reassignment NPD
• North Carolina Luna Care Physical Therapy LLC

  • Physical Therapist
  • Hendersonville, NC
  • NPI 1124626148
  Medicare reassignment NPD
• Cleveland Physical Therapy Associates Inc

  • Physical Therapy Clinic/Center
  • Shelby, NC
  • NPI 1093718199
  NPD
• Duke University Health System, Inc.

  dba Duke Home Infusion

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Durham, NC
  • NPI 1427187525
  NPD
• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1528683935
  NPD

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1891413480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W KING ST STE 9",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280863437",
            "telephone_number": "704-739-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILEBAUM",
        "first_name": "JOHNNY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Michelle Parrish, NP
• Paul E Hendricks Jr DDS
• Betsy Perez-Luna, MA
• Lisa Petty-Hartgrove, DBA
• Pharmaceutical Specialties LLC (Maxor Specialty Pharmacy)
• Piedmont Pediatric Therapy
• Jessica Marie Pineda, PA-C
• Premier Service of Carolina, Inc
• Prescriptions Plus II Inc (Prescriptions Plus)
• Allan Marion Propst, PHARMACIST

• Physical Therapist in Kings Mountain, NC
• Providers in Kings Mountain, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.