Individual provider Active NPI

Victoria Simon, DPT

  • Physical Therapist
  • Mt Pleasant, SC
National Provider Identifier
1023586641
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8658 Issued in SC
Practice address
1106 Chuck Dawley Blvd Ste 200
Mt Pleasant, SC 29464-4195
Phone
(843) 849-1551
Fax
(843) 654-8846
NPI assigned
Nov 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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 8658 SC Primary

Addresses

Primary practice location

1106 Chuck Dawley Blvd Ste 200
Mt Pleasant, SC 29464-4195

Mailing address

1106 Chuck Dawley Blvd Ste 200
Mt Pleasant, SC 29464-4195
Phone (843) 849-1551

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
8658SCMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1023586641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 CHUCK DAWLEY BLVD STE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294644195",
            "telephone_number": "843-849-1551",
            "fax_number": "843-654-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 CHUCK DAWLEY BLVD STE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294644195",
            "telephone_number": "843-849-1551",
            "fax_number": "843-654-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "VICTORIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.