Individual provider Active NPI

Tammy C Gantzer, PT

  • Physical Therapist
  • Rock Hill, SC
National Provider Identifier
1013001981
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3445 Issued in SC
Practice address
134 Professional Park Drive
Rock Hill, SC 29732-1178
Phone
(803) 329-4685
Fax
(803) 329-4683
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3445 SC Primary
Orthopedic Physical Therapist 2251X0800X 3445 SC

Addresses

Primary practice location

134 Professional Park Drive
Rock Hill, SC 29732-1178

Mailing address

105 Ben Casey Drive
Suite 127
Fort Mill, SC 29708-8561
Phone (803) 802-5855

Other identifiers 1

IdentifierTypeStateIssuer
GP4586MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061205000140 SC Practitioner - Physical Therapist in Private Practice 0042219834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Rehabilitation Specialists LLCGroup PAC ID 1951311208, 7 clinicians

Practice addresses (Care Compare)

1757 Ebenezer Rd
Rock Hill, SC 29732-1101
Phone (803) 329-4685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3445SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Rehabilitation Specialists, LLC Physical Therapist CurrentSince Dec 4, 2006 Accepting new patients
Palmetto Rehabilitation Specialists, LLC Physical Therapist PastSince Dec 4, 2006 Accepting new patients
Carolina Orthopaedic Surgery Associates, P.a. Past Accepting new patients

Locations

105 Ben Casey Dr
Ste 127
Fort Mill, SC 29708
Phone (803) 448-3200

1757 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 329-4685

134 Professional Park Dr
Rock Hill, SC 29732
Phone (803) 329-3130

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6315/brand/3/csg/1/fhir/r4

Organizations & group practices 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1013001981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DRIVE",
            "address_2": "SUITE 127",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088561",
            "telephone_number": "803-802-5855",
            "fax_number": "803-802-5869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 PROFESSIONAL PARK DRIVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321178",
            "telephone_number": "803-329-4685",
            "fax_number": "803-329-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTZER",
        "first_name": "TAMMY",
        "middle_name": "C",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "3445",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "SC",
            "license": "3445",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4586",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; 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.