Longevity PT

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

4916 Issued in SC

Legal business name

LONGEVITY PT

Practice address

5524 Gallatin LN
N Charleston, SC 29420-6803

Phone

(843) 906-7169

NPI assigned

Mar 3, 2016

Last updated

Mar 3, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dale L Kukla, P.T.NPI 1922499755

Title

Owner/Physical Therapist

Phone

(843) 906-7169

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dale Kukla, P.T

  • Physical Therapist
  • N Charleston, SC
  • NPI 1922499755
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1003276049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5524 GALLATIN LN",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294206803",
            "telephone_number": "843-906-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5524 GALLATIN LN",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294206803",
            "telephone_number": "843-906-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "KUKLA",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "843-906-7169",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "4916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Chandler Lista, RPH
• Littles of the Lowcountry Therapy Services
• Amanda Allen Littleton, APRN
• Mary A Lobianco, RN
• Whitney Long
• Low Country Family Podiatry
• Low Country Pathology Associates PA
• Lowcountry Cardiology Associates, PA
• Lowcountry Hand Center, PC
• Lowcountry Medical Associates (LMA Ancilliary Billing Dept)

• Home Health Agency in N Charleston, SC
• Providers in N Charleston, SC by specialty
• Home Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.