POLARIS REHABILITATION, LLC (NPI# 1114467701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114467701 |
| Entity Type | Organization |
| Organization Name | POLARIS REHABILITATION, LLC |
| Practice Address |
1620 Us 1 Hwy Youngsville NC 27596-9219 |
| Mailing Address |
2208 Rainy Lake St Wake Forest NC 27587-3423 |
| Practice Telephone | 9842370096 |
| Practice Fax Number | 8008773496 |
| Mailing Telephone | 6303620029 |
| Mailing Fax Number | 8008773496 |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2020-01-02 |
| Authorized Official Name | JOHN DEGUZMAN (ORGANIZER/MEMBER) |
| Authorized Official Telephone | 6303620029 |
| Authorized Official Credential | C.PED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | P10385 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Street Address |
1620 US 1 HWY |
| City | YOUNGSVILLE |
| State | NC |
| Zip Code | 27596-9219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750314910 | Alma Deguzman | Physical Therapist | 1620 Us 1 Hwy, Youngsville, NC 27596-9219 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144879313 | Harp Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 12339 Wake Union Church Rd Ste 108, Wake Forest, NC 27596 | 2019-09-10 |
| 1326560806 | Nirali Patel | Pharmacist | 1190 Us Hwy 1n, Youngsville, NC 27596 | 2017-07-17 |
| 1790109577 | Riphen Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 203 Blue Heron Drive, Youngsville, NC 27596 | 2014-02-13 |
| 1831524768 | Janice D Clark, Dds, Pa | Dentist | 680 Us Hwy 1 N, Suite 500, Youngsville, NC 27596 | 2013-09-11 |
| 1720372733 | Sherri Culbertson | Pharmacist | 1190 Us Hwy 1 North, Youngsville, NC 27596 | 2011-06-07 |
| 1326368390 | Trg Health Care Systems LLC | Social Worker | 112 Wheaton Ave, Suite B, Youngsville, NC 27596 | 2010-06-01 |
| 1932250065 | Catherine Grace Busam | Counselor | 90 Wheaton Dr, Youngsville, NC 27596 | 2007-01-16 |
| 1316022700 | Emmett Smoak Ackermon Jr. | Dentist | 66 Wheaton Ave, Youngsville, NC 27596 | 2006-10-26 |
| 1750323960 | Matthew Mullen | Specialist | 700 Us 1 Hwy Ste 100, Youngsville, NC 27596 | 2006-06-12 |
| 1992074314 | Trg Health Care Systems LLC | Community/Behavioral Health | 112 Wheaton Ave, Suite B, Youngsville, NC 27596 | 2011-12-14 |
| Find all providers in zip 27596 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659970770 | Survivor Friendly LLC | Prosthetic/Orthotic Supplier | 527 Keisler Dr Ste 104, Cary, NC 27518-9306 | 2020-10-20 |
| 1154920395 | Anderson Prosthetics & Orthotics, LLC | Prosthetic/Orthotic Supplier | 307 W Tremont Ave Ste 200, Charlotte, NC 28203-4902 | 2020-10-20 |
| 1528666195 | Skyland Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 1141 Tunnel Rd Ste E, Asheville, NC 28805-2037 | 2020-10-15 |
| 1982202545 | Davidson Prosthetics & Orthotics | Prosthetic/Orthotic Supplier | 845 Church St N Ste 205, Concord, NC 28025-4374 | 2020-10-15 |
| 1891301156 | Tys Cranial Prothesis | Prosthetic/Orthotic Supplier | 2400 S Memorial Dr Ste 3b, Greenville, NC 27834-5031 | 2020-09-21 |
| 1124645882 | The Royal Stich By Melinda | Prosthetic/Orthotic Supplier | 8032 Black Forest Ln Apt 10103, Charlotte, NC 28277-6746 | 2020-06-29 |
| 1073134573 | Diva Salon By Veronica Ashley, Inc. | Prosthetic/Orthotic Supplier | 10901 University City Blvd Ste 108, Charlotte, NC 28213-9300 | 2020-05-06 |
| 1841819711 | Sc&f Enterprises, LLC | Prosthetic/Orthotic Supplier | 2187 Skibo Rd, Fayetteville, NC 28314-0264 | 2020-04-10 |
| 1457986499 | Lala Lashes Charlotte | Prosthetic/Orthotic Supplier | 2434 Shad Ct, Charlotte, NC 28208-3307 | 2020-03-10 |
| 1871125237 | Elite Hair Replacement Inc | Prosthetic/Orthotic Supplier | 2110 Fort Bragg Rd Ste 112, Fayetteville, NC 28303-7036 | 2020-02-04 |
| Find all providers with the same taxonomy | ||||
| City | YOUNGSVILLE |
| Zip Code | 27596 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.