Kevin Joseph Cleary, P.T.
Individual provider Active NPI Sports Physical Therapist · Clemmons, NC
NPI 1891809570 · NPPES record last updated Feb 20, 2026
Key facts
- NPI
- 1891809570
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Physical Therapist 2251S0007X
- License
- 8203 (NC)
- Practice address
- 3311 Jessie Village Dr
Clemmons, NC 27012-9963 - Phone
- (336) 765-7058
- Fax
- (336) 329-8241
- NPI assigned
- Aug 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aware Physical Therapy LLC
Practice addresses (Care Compare)
1315 S Hawthorne Rd
Winston Salem, NC 27103-4121
Phone (336) 917-6000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110803000005 | NC | Practitioner - Physical Therapist in Private Practice | 8123297439 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8203 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aware Physical Therapy,LLC | Current |
Accepting new patients | |
| Brandon Rehabilitation, LLC | Past | Accepting new patients |
Locations
5380 US Highway 158
Ste 205
Advance, NC 27006
Phone (336) 940-6415
1315 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 917-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 8203 | NC | Yes |
| Orthopedic Physical Therapist | 2251X0800X | 8203 | NC |
Addresses
Primary practice location
3311 Jessie Village Dr
Clemmons, NC 27012-9963
Mailing address
3311 Jessie Village Dr
Clemmons, NC 27012-9963
Phone (336) 765-7058
Other providers in Clemmons, NC
- TSZ Hin Choi
- Jerry L Chostner
- Marissa Christian
- Bradley Walton Clark
- Joanne Clarkin Gonzalez
- Alyssa Laura Clements
- Clemmons Assisted Living LLC
- Clemmons Dermatology
- Clemmons Family Eye Care
- Clemmons Psychiatric Associates
All providers in Clemmons, NC · Sports Physical Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.