Provider Demographics
NPI:1831230382
Name:CARTER, CASEY C (ATC, MS, DPT)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:C
Last Name:CARTER
Suffix:
Gender:M
Credentials:ATC, MS, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 ROCKY RIDGE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-4446
Mailing Address - Country:US
Mailing Address - Phone:615-972-2800
Mailing Address - Fax:
Practice Address - Street 1:460 GREAT CIRCLE RD
Practice Address - Street 2:BAPTIST SPORTS PARK
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1404
Practice Address - Country:US
Practice Address - Phone:615-565-4090
Practice Address - Fax:615-565-4092
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN83672251S0007X
AL1-0490225100000X
TN08882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer