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CAROLINA CONCUSSION & PHYSICAL MEDICINE, PLLC
NPI 1124544499
Chiropractor - Rehabilitation in Wake Forest, NC

Active since August 18, 2017
120 CAPCOM AVEUNE, SUITE 104, WAKE FOREST, NC 27587(301) 922-6188 Get Directions Write a Review

NPPES record last updated: May 20, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 20, 2018, Aug 18, 2017 (2 updates tracked since 2017).

About Carolina Concussion & Physical Medicine, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAROLINA CONCUSSION & PHYSICAL MEDICINE, PLLC (NPI 1124544499) is a healthcare organization registered as a rehabilitation in Wake Forest, North Carolina and active in the NPI registry since August 2017. The organization lists Michael S. Decriscio, Member, as its authorized official.

NPPES Registry Identity

NPI1124544499
Entity TypeOrganization
Primary Taxonomy111NR0400X
Legal Business NameCAROLINA CONCUSSION & PHYSICAL MEDICINE, PLLC
Location Address120 CAPCOM AVEUNE, SUITE 104Wake Forest, NC 27587
Mailing Address7900 Woodcross WayWake Forest, NC 27587-8328 · (301) 922-6188
Phone(301) 922-6188
Organization SubpartNo
Authorized OfficialMichael S. DecriscioMember · (301) 922-6188
Enumeration DateAugust 18, 2017
Last NPPES UpdateMay 20, 20182 updates tracked since enumeration
✔ NPI 1124544499 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractor · RehabilitationChiropractic Providers
Taxonomy Code111NR0400X
License✔ Licensed in NC · 4670
Definition
Rehabilitation is the discipline focused on restoring a patient's functional abilities to pre-injury or pre-disease status. Functional abilities are defined as those activities in one's daily life, work, or sports and recreational activities that an individual participates in. Relevant impairments (e.g. strength, endurance, flexibility, motor control, etc.) are often intermediate goals of rehabilitation, but the final goal of successful care is return to participation in activities in which the patient was successful before the onset of the injury or disease. Essential to a rehabilitation approach is a focus on patient-centered outcomes such as independence and self-management or self-care skills.
120 CAPCOM AVEUNE, Wake Forest, NC 27587
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carolina Concussion & Physical Medicine, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Carolina Concussion & Physical Medicine, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Michael Decriscio, D.C.
Chiropractic
NPI 1063541464
376 MILL ST
Hagerstown, MD 21740
(301) 739-0090
258 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carolina Concussion & Physical Medicine, PLLC's NPI number?

The NPI number for Carolina Concussion & Physical Medicine, PLLC is 1124544499. It was assigned to this organization in the NPPES registry on August 18, 2017.

Where is Carolina Concussion & Physical Medicine, PLLC located?

Carolina Concussion & Physical Medicine, PLLC is located at 120 Capcom Aveune Suite 104, Wake Forest, NC 27587. The listed phone number is (301) 922-6188.

What is Carolina Concussion & Physical Medicine, PLLC's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Rehabilitation, with taxonomy code 111NR0400X.

Is Carolina Concussion & Physical Medicine, PLLC enrolled in Medicare?

Yes. Carolina Concussion & Physical Medicine, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Carolina Concussion & Physical Medicine, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Carolina Concussion & Physical Medicine, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Carolina Concussion & Physical Medicine, PLLC was last updated on May 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.