Individual provider Active NPI

Colton Chase Cantley, DPT, PT

  • Physical Therapist
  • Clemson, SC
National Provider Identifier
1003679788
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12248 Issued in SC
Practice address
379 Old Greenville Hwy Ste 101
Clemson, SC 29631-3156
Phone
(864) 624-0120
NPI assigned
Feb 5, 2024
Last updated
Mar 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12248 SC Primary

Addresses

Primary practice location

379 Old Greenville Hwy Ste 101
Clemson, SC 29631-3156

Mailing address

203 Tulip Tree CT
Easley, SC 29642-7600
Phone (740) 525-5240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240424000178 SC Practitioner - Physical Therapist in Private Practice 7012356082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

379 Old Greenville Hwy
Suite 101
Clemson, SC 29631-3156
Phone (864) 624-0120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12248SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Feb 27, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince Feb 27, 2024 Accepting new patients

Locations

379 Old Greenville Hwy
Ste 101
Clemson, SC 29631
Phone (864) 624-0120

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1003679788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 TULIP TREE CT",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296427600",
            "telephone_number": "740-525-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 OLD GREENVILLE HWY STE 101",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296313156",
            "telephone_number": "864-624-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTLEY",
        "first_name": "COLTON",
        "middle_name": "CHASE",
        "credential": "DPT, PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.