Individual provider Active NPI

Jenna Thom Sires, PT, DPT

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1023314879
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6360 Issued in SC
Practice address
1003 Grove Rd Ste C
Greenville, SC 29605-4626
Phone
(864) 365-6051
Fax
(864) 752-0976
NPI assigned
Jan 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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 6360 SC Primary

Addresses

Primary practice location

1003 Grove Rd Ste C
Greenville, SC 29605-4626

Mailing address

1003 Grove Rd Ste C
Greenville, SC 29605-4626
Phone (864) 365-6051

Other names 1

  • Jenna Thom 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6360SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Pelvic Health and Wellness CurrentSince May 1, 2020 Accepting new patients
The Sigurd Center for Ortho & Neuro Rehab Physical Therapist PastSince Mar 8, 2006 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist Past Accepting new patients
Medsource Inc. Past Accepting new patients

Locations

1003 Grove Rd
Ste C
Greenville, SC 29605
Phone (864) 365-6051

608 Grove Rd
Greenville, SC 29605
Phone (864) 365-6051

Organizations & group practices 4

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": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1023314879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 GROVE RD STE C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054626",
            "telephone_number": "864-365-6051",
            "fax_number": "864-752-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 GROVE RD STE C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054626",
            "telephone_number": "864-365-6051",
            "fax_number": "864-752-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRES",
        "first_name": "JENNA",
        "middle_name": "THOM",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "THOM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.