Provider Demographics
NPI:1164460093
Name:REHABILITATION INSTITUTE OF THE CAROLINAS
Entity Type:Organization
Organization Name:REHABILITATION INSTITUTE OF THE CAROLINAS
Other - Org Name:PRESBYTERIAN CENTER FOR PREVENTIVE CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT PRESBYTERIAN HEALTHCARE C
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-384-6370
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-9679
Mailing Address - Fax:704-316-0508
Practice Address - Street 1:125 BALDWIN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3227
Practice Address - Country:US
Practice Address - Phone:704-384-5043
Practice Address - Fax:704-384-8895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0151FOtherBCBS NC
NC890151FMedicaid
NCCA0623OtherRAILROAD MEDICARE
NC2309945Medicare PIN