NPIMap

Organization Active NPI

Drayer Physical Therapy-South Carolina, LLC

  • Physical Therapist
  • Chapin, SC
National Provider Identifier
1013376821
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DRAYER PHYSICAL THERAPY-SOUTH CAROLINA, LLC
Practice address
130 Amicks Ferry Rd
Suite G
Chapin, SC 29036-9400
Phone
(803) 932-2176
Fax
(803) 932-2657
NPI assigned
Feb 22, 2016
Last updated
Apr 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Authorized official

Name
Eric J Williams
Title
President and Ceo
Phone
(717) 220-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

130 Amicks Ferry Rd
Suite G
Chapin, SC 29036-9400

Mailing address

10 William Pope Dr
Suite 3
Bluffton, SC 29909-7549
Phone (843) 705-9440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131004000553 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315171394 Receives reassigned benefits from 292 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Irmo, SC; Lexington, SC; Elgin, SC; Columbia, SC; Chapin, SC; Cayce, SC; Camden, SC; Blythewood, SC

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

130 Amicks Ferry Rd
#G
Chapin, SC 29036
Phone (803) 932-2176

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461283200000",
    "number": "1013376821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WILLIAM POPE DR",
            "address_2": "SUITE 3",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299097549",
            "telephone_number": "843-705-9440",
            "fax_number": "843-705-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 AMICKS FERRY RD",
            "address_2": "SUITE G",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290369400",
            "telephone_number": "803-932-2176",
            "fax_number": "803-932-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYER PHYSICAL THERAPY-SOUTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-22",
        "last_updated": "2016-04-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "717-220-2100"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapin, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.