NPI Code Detail JSON Logo

1124719778 NPI number — NC PHYSICAL THERAPY AND BALANCE LLC

NPI Number: 1124719778
Health Care Provider/Practitioner: NC PHYSICAL THERAPY AND BALANCE LLC

Information about “1124719778” NPI (NC PHYSICAL THERAPY AND BALANCE LLC) exists in 1124719778 in HTML format HTML  |  1124719778 in plain Text format TXT  |  1124719778 in PDF (Portable Document Format) PDF  |  1124719778 in an XML format XML  formats.

NPI Number : 1124719778 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124719778",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NC PHYSICAL THERAPY AND BALANCE LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6000 SARAHCREEK CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RALEIGH",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27607-4866",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "919-244-2225",
    "MailingAddressFaxNumber": "919-446-3959",
    "FirstLinePracticeLocationAddress": "3010 ANDERSON DR STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RALEIGH",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27609-7720",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "199-244-2225",
    "PracticeLocationAddressFaxNumber": "919-446-3959",
    "EnumerationDate": "05/16/2023",
    "LastUpdateDate": "01/06/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FREATHY",
    "AuthorizedOfficialFirstName": "BRADLEY",
    "AuthorizedOfficialMiddleName": "ALLAN",
    "AuthorizedOfficialTitle": "OWNER MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "813-498-7048",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QP2000X",
        "TaxonomyName": "Physical Therapy Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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