# MEDICAL ATHLETICS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528320702
- **Authorized official:** MS. SHADAWN STOKES MHSA (SENIOR EXECUTIVE FOR HEALTHCARE ADM)
- **Authorized official phone:** (704) 557-0132

## Contact information

- **Practice address:** 8535 CLIFF CAMERON DR, SUITE 116, CHARLOTTE, NC 28269-5908
- **Practice address phone:** (704) 557-0132
- **Practice address fax:** (877) 284-0039
- **Mailing address:** 3020 PROSPERITY CHURCH RD, SUITE I \#174, CHARLOTTE, NC 28269-7197
- **Mailing address phone:** (704) 557-0132
- **Mailing address fax:** (877) 284-0039

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NC | Yes |

## Other

- **Enumeration date:** 06/13/2012
- **Last updated:** 08/06/2012