Individual provider Active NPI

Jessica Rayder

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1962124164
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
TBD Issued in NC
Practice address
8305 Falls of Neuse Rd Ste 102
Raleigh, NC 27615-3546
Phone
(919) 870-4444
NPI assigned
Sep 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X TBD NC Primary

Addresses

Primary practice location

8305 Falls of Neuse Rd Ste 102
Raleigh, NC 27615-3546

Mailing address

8305 Falls of Neuse Rd Ste 102
Raleigh, NC 27615-3546
Phone (919) 870-4444

Other identifiers 1

IdentifierTypeStateIssuer
TBDOtherNCNC PT BOARD OF EXAMINERS

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://npiregistry.cms.hhs.gov/search Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221101001907 NC Practitioner - Physical Therapist in Private Practice 9638546864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aquatic Physical Therapy and Beyond, LLCGroup PAC ID 2668450008, 5 clinicians

Practice addresses (Care Compare)

8305 Falls of Neuse Rd
Suite 102
Raleigh, NC 27615-3546
Phone (919) 870-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TBDNCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aquatic Physical Therapy & Beyond, LLC Physical Therapist CurrentSince Sep 20, 2022 Accepting new patients

Locations

8305 Falls of Neuse Rd
Ste 102
Raleigh, NC 27615
Phone (919) 870-4444

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1962124164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8305 FALLS OF NEUSE RD STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153546",
            "telephone_number": "919-870-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8305 FALLS OF NEUSE RD STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153546",
            "telephone_number": "919-870-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYDER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "TBD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC PT BOARD OF EXAMINERS",
            "identifier": "TBD",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://npiregistry.cms.hhs.gov/search",
            "affiliation": "N",
            "endpointDescription": "NPI Registry",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8305 Falls Of Neuse Rd Ste 102",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276153546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 14, 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.