Active NPI
Leogardo Salva Racelis, PT
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1902243710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14200
- Practice address
- 2626 Glenwood Ave Ste 160
Raleigh, NC 27608-1367 - Phone
- (919) 781-9565
- Fax
- (919) 781-9564
- NPI assigned
- Jun 3, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14200 | NC | Primary |
Addresses
Primary practice location
2626 Glenwood Ave Ste 160
Raleigh, NC 27608-1367
Mailing address
1997 Waterford Village Dr
Clemmons, NC 27012-9381
Phone (336) 201-8660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14200 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370217600000",
"number": "1902243710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1997 WATERFORD VILLAGE DR",
"city": "CLEMMONS",
"state": "NC",
"postal_code": "270129381",
"telephone_number": "336-201-8660",
"fax_number": "336-201-8660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2626 GLENWOOD AVE STE 160",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276081367",
"telephone_number": "919-781-9565",
"fax_number": "919-781-9564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RACELIS",
"first_name": "LEOGARDO",
"middle_name": "SALVA",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-03",
"last_updated": "2013-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "14200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.