Providence Physical Therapy & Performance, LLC.
NPI 1104279520 · Physical Therapy Clinic/Center · Tabor City, NC
Providence Physical Therapy & Performance, LLC. is a Physical Therapy Clinic/Center organization in Tabor City, NC (NPI 1104279520).
Provider details
- NPI number
- 1104279520
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kevin Bullard, Physical Therapist/Owner/Manager(252) 916-9949
- License
- 10244 (NC)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2016-07-20
- Last updated
- 2017-02-06
Frequently asked questions
- What is Providence Physical Therapy & Performance, LLC.'s NPI number?
- Providence Physical Therapy & Performance, LLC.'s National Provider Identifier (NPI) is 1104279520, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Physical Therapy & Performance, LLC.?
- Providence Physical Therapy & Performance, LLC. is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is Providence Physical Therapy & Performance, LLC. located?
- Providence Physical Therapy & Performance, LLC.'s practice location on file with NPPES is 107 Live Oak St, Tabor City, NC 28463-2042.
- What is Providence Physical Therapy & Performance, LLC.'s phone number?
- The practice phone number listed in the NPPES registry for Providence Physical Therapy & Performance, LLC. is (252) 916-9949.
- Who is the authorized official for Providence Physical Therapy & Performance, LLC.?
- The authorized official listed on Providence Physical Therapy & Performance, LLC.'s NPPES record is Kevin Bullard, Physical Therapist/Owner/Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Physical Therapy & Performance, LLC.'s NPI active?
- Yes — Providence Physical Therapy & Performance, LLC.'s NPI (1104279520) is active in the NPPES registry as of the last update on 2017-02-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.