1235762352 NPI number — DR. HEATHER PEARSON CARUOLO DPT

Table of content: DR. HEATHER PEARSON CARUOLO DPT (NPI 1235762352)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235762352 NPI number — DR. HEATHER PEARSON CARUOLO DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARUOLO
Provider First Name:
HEATHER
Provider Middle Name:
PEARSON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235762352
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7391 ADIRONDACK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28037-0199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-260-1041
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 NC-16 BUSINESS
Provider Second Line Business Practice Location Address:
#203
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-212-7050
Provider Business Practice Location Address Fax Number:
980-212-7051
Provider Enumeration Date:
02/17/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  P19393 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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