NPIMap

Organization Active NPI

Propel Pediatric Therapy

  • Pediatric Physical Therapist
  • Kernersville, NC
National Provider Identifier
1992007546
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
10601 Issued in NC
Legal business name
PROPEL PEDIATRIC THERAPY
Practice address
1125 Pine Knolls Rd
Kernersville, NC 27284-8232
Phone
(336) 497-3072
Fax
(336) 497-3072
NPI assigned
Dec 1, 2010
Last updated
Dec 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Lara Ring, PTNPI 1699899294
Title
Owner
Phone
(336) 404-1684

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251P0200X 10601 NC Primary

Addresses

Primary practice location

1125 Pine Knolls Rd
Kernersville, NC 27284-8232

Mailing address

1125 Pine Knolls Rd
Kernersville, NC 27284-8232
Phone (336) 497-3072

Other identifiers 1

IdentifierTypeStateIssuer
7212106MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Propel Pediatric Therapy2 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.

Locations

6338 Cephis Dr
Clemmons, NC 27012
Phone (336) 893-6383

6346 Cephis Dr
Clemmons, NC 27012
Phone (336) 404-1684

1130D Snow Bridge Ln
Kernersville, NC 27284
Phone (336) 904-0467

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1992007546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 PINE KNOLLS RD",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848232",
            "telephone_number": "336-497-3072",
            "fax_number": "336-497-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 PINE KNOLLS RD",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848232",
            "telephone_number": "336-497-3072",
            "fax_number": "336-497-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROPEL PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-404-1684",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "10601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212106",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.