Individual provider Active NPI

Tanya Natasha Sotillo, PT

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1972682755
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P16817 Issued in NC
Practice address
9216 Ardrey Kell Rd Ste 300
Charlotte, NC 28277-4954
Phone
(980) 556-7330
Fax
(980) 939-8215
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01192 NJ
Physical Therapist 225100000X 9599 SC
Physical Therapist 225100000X P16817 NC Primary

Addresses

Primary practice location

9216 Ardrey Kell Rd Ste 300
Charlotte, NC 28277-4954

Mailing address

1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200

Other practice location 1

219 Richmond Ave
New Milford, NJ 07646-2517
Phone (201) 907-3150

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190628000131 NC Practitioner - Physical Therapist in Private Practice 1658344791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Texas Medical Branch at Galveston, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

3627 Beatties Ford Rd
Suite 200
Charlotte, NC 28216-3249
Phone (984) 297-8155

9216 Ardrey Kell Rd
Suite 300
Charlotte, NC 28277-4954
Phone (980) 556-7330

9392 Sullivan Vale LN
Charlotte, NC 28215-7073
Phone (980) 701-5757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01192NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab North Carolina LLC Physical Therapist CurrentSince Apr 20, 2019 Accepting new patients
Ivyrehab North Carolina LLC CurrentSince Apr 20, 2019 Accepting new patients
Genesis Medical Health PC Past Accepting new patients
B Stern Physical Therapy P.C. Physical Therapist PastSince Jun 15, 2013 Accepting new patients

Locations

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

9325 Jw Clay Blvd
Ste 224
Charlotte, NC 28262
Phone (704) 755-4278

9392 Sullivan Vale Ln
Charlotte, NC 28215
Phone (980) 701-5757

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

Organizations & group practices 4

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1972682755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9216 ARDREY KELL RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774954",
            "telephone_number": "980-556-7330",
            "fax_number": "980-939-8215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 Richmond Ave",
            "address_purpose": "LOCATION",
            "city": "New Milford",
            "state": "NJ",
            "postal_code": "076462517",
            "country_code": "US",
            "telephone_number": "201-907-3150",
            "fax_number": "201-907-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOTILLO",
        "first_name": "TANYA",
        "middle_name": "NATASHA",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01192",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9599",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P16817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.