Provider Demographics
NPI:1427142561
Name:CAROLINA REHABILITATION INC
Entity type:Organization
Organization Name:CAROLINA REHABILITATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAUGHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-981-6519
Mailing Address - Street 1:121 ALHAMBRA PLZ STE 1100
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4522
Mailing Address - Country:US
Mailing Address - Phone:502-609-4872
Mailing Address - Fax:910-457-0114
Practice Address - Street 1:4330 SOUTHPORT SUPPLY RD SE STE 201
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-9273
Practice Address - Country:US
Practice Address - Phone:910-457-0113
Practice Address - Fax:910-457-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211899Medicaid
NC2500245Medicare PIN