Individual provider Active NPI

Jennifer Lynne Poirier, DPT

  • Physical Therapist
  • Fort Mill, SC
National Provider Identifier
1013148477
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P12298 Issued in NC
Practice address
1281 Lurecliff PL
Fort Mill, SC 29708-8905
Phone
(978) 766-8320
NPI assigned
Aug 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 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 P12298 NC Primary

Addresses

Primary practice location

1281 Lurecliff PL
Fort Mill, SC 29708-8905

Mailing address

1281 Lurecliff PL
Fort Mill, SC 29708-8905
Phone (978) 766-8320

Other names 1

  • Jennifer Lynne Wall Former name

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
P12298NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Energize Therapy Services, PC CurrentSince Jun 14, 2020 Accepting new patients
Chit Chat Speech Language Therapy Past Accepting new patients
Arise and Shine Therapy, Inc. Physical Therapist Past Accepting new patients

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": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1013148477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 LURECLIFF PL",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088905",
            "telephone_number": "978-766-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 LURECLIFF PL",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088905",
            "telephone_number": "978-766-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POIRIER",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-04",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P12298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WALL",
            "middle_name": "LYNNE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.