Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
MBODY PHYSICAL THERAPY, LLC
Active
Organization
MBODY PHYSICAL THERAPY, LLC
Active
Other names
MBody Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA MARIE VANDER BLOOMER PT (OWNER / PHYSICAL THERAPIST)
(980) 288-4646
Entity
Organization
Contact information
Practice address
5200 PARK ROAD, SUITE 235, CHARLOTTE, NC 28209-3651
(980) 288-4646
Mailing address
5200 PARK ROAD, SUITE 235, CHARLOTTE, NC 28209-3651
(980) 288-4646
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
14338
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q44318A
MEDICARE PTAN
NC
Enumeration date
06/24/2015
Last updated
06/25/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up