NPIMap

Organization Active NPI

Carolina Rehab Incorporation

  • Physical Therapist
  • Statesville, NC
National Provider Identifier
1972633956
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CAROLINA REHAB INCORPORATION
Practice address
889 Sherwood Lane
Statesville, NC 28677-3414
Phone
(704) 881-0088
Fax
(704) 881-0087
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Authorized official

Name
Mr. Jeffrey James Faulk,Jr, P.T., C.H.T.
Title
Owner
Phone
(704) 881-0088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

889 Sherwood Lane
Statesville, NC 28677-3414

Mailing address

889 Sherwood LN
Statesville, NC 28677-4183
Phone (704) 881-0088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040930001198 NC Part B Supplier - Clinic/Group Practice 3173592581 Receives reassigned benefits from 7 practitioners
Practice locations: Statesville, NC

National Provider Directory

National Provider Directory

Locations

363 Williamson Rd
Ste 101
Mooresville, NC 28117
Phone (704) 660-7070

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1972633956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 SHERWOOD LN",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774183",
            "telephone_number": "704-881-0088",
            "fax_number": "704-881-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 SHERWOOD LANE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773414",
            "telephone_number": "704-881-0088",
            "fax_number": "704-881-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA REHAB INCORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "FAULK,JR",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-881-0088",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T., C.H.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.