S.T.a.C.K. Physical Therapy & Corrective Exercise, Incorporated

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

8899 Issued in NC

Legal business name

S.T.A.C.K. PHYSICAL THERAPY & CORRECTIVE EXERCISE, INCORPORATED

Practice address

1640 Eva Mae Dr
Raleigh, NC 27610-4443

Phone

(800) 362-0903

Fax

(866) 434-5096

NPI assigned

Aug 21, 2007

Organization subpart

No

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

Authorized official

Name

Kenneth P. Stack, M.S.,P.T.,C.S.C.S.

Title

President

Phone

(800) 362-0903

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Arder 'Scott' Campbell, P.T.

  • Physical Therapist
  • Raleigh, NC
  • NPI 1821252792
  NPD (past)
• Katie D. Marakas, DPT

  • Physical Therapist
  • Raleigh, NC
  • NPI 1790018737
  NPD (past)

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255910400000",
    "number": "1912190174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 EVA MAE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276104443",
            "telephone_number": "800-362-0903",
            "fax_number": "866-434-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 EVA MAE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276104443",
            "telephone_number": "800-362-0903",
            "fax_number": "866-434-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.T.A.C.K. PHYSICAL THERAPY & CORRECTIVE EXERCISE, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2009-10-19",
        "status": "A",
        "authorized_official_last_name": "STACK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "18003620903",
        "authorized_official_credential": "M.S.,P.T.,C.S.C.S."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NC",
            "license": "8899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physical Therapy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2009; 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.