Healthcare Provider Details

I. General information

NPI: 1427142561
Provider Name (Legal Business Name): CAROLINA REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEDICAL CAMPUS DR NW STE 104
SUPPLY NC
28462-4094
US

IV. Provider business mailing address

121 ALHAMBRA PLZ STE 1100
CORAL GABLES FL
33134-4522
US

V. Phone/Fax

Practice location:
  • Phone: 910-755-5861
  • Fax: 910-755-5865
Mailing address:
  • Phone: 502-609-4872
  • Fax: 910-457-0114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: TRACEY J BAUGHEY
Title or Position: CREDENTIALING
Credential:
Phone: 267-981-6519