NPIMap

Organization Active NPI

Proactive Therapy of North Carolina Inc

Doing business as Select Physical Therapy

  • Rehabilitation Clinic/Center
  • Ahoskie, NC
National Provider Identifier
1902405178
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PROACTIVE THERAPY OF NORTH CAROLINA INC
Doing business as
Select Physical Therapy
Practice address
1109 Memorial Dr E
Ahoskie, NC 27910-3919
Phone
(252) 332-6760
NPI assigned
Oct 20, 2020
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
John F Duggan
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

1109 Memorial Dr E
Ahoskie, NC 27910-3919

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other names 1

  • Select Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130207000475 NC Part B Supplier - Clinic/Group Practice 6305753120 Receives reassigned benefits from 88 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marion, NC; Raleigh, NC; Pittsboro, NC; Rocky Mount, NC; Sanford, NC; Southern Pines, NC; Swannanoa, NC; Wake Forest, NC…
O20201119003511 NC Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 6305753120 Practice locations: Ahoskie, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902405178. Details of each certification follow.

  • CCN 346696 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 346696

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SELECT PHYSICAL THERAPY
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Feb 22, 2022
Last certification
Feb 22, 2022
Ownership / control type
Proprietary
Facility address
1109 Memorial Drive E
Ahoskie, NC 27910

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Proactive Therapy of North Carolina Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1109 Memorial Dr E
Ahoskie, NC 27910
Phone (252) 332-6760

Practitioners & affiliated clinicians

Practitioners 7

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": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1902405178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 MEMORIAL DR E",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279103919",
            "telephone_number": "252-332-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE THERAPY OF NORTH CAROLINA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Select Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ahoskie, NC

Sources for this page

Verify at the official NPI Registry.