Individual provider Active NPI

Michael A Imperial, DPT

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1003928771
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5219 Issued in SC
Practice address
1924 Main St
Columbia, SC 29201-2412
Phone
(803) 434-2300
Fax
(803) 434-8600
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 5219 SC Primary

Addresses

Primary practice location

1924 Main St
Columbia, SC 29201-2412

Mailing address

5 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone (803) 434-2300

Other practice location 1

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mimperial6790@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5219SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients
Medically Fragile Children'S Program Past Accepting new patients

Locations

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Interoperability endpoints

  • Direct secure messaging: mimperial6790@direct.lexmed.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1003928771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 RICHLAND MEDICAL PARK DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036863",
            "telephone_number": "803-434-2300",
            "fax_number": "803-434-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 MAIN ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012412",
            "telephone_number": "803-434-2300",
            "fax_number": "803-434-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2720 Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291694810",
            "country_code": "US",
            "telephone_number": "803-791-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMPERIAL",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mimperial6790@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2720 Sunset Blvd",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.