Individual provider Active NPI

Jessica T Stubbs, PT

  • Physical Therapist
  • Travelers Rest, SC
National Provider Identifier
1033482575
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.6633PT Issued in SC
Practice address
146 Walnut LN Ste a
Travelers Rest, SC 29690-1672
Phone
(864) 834-0401
Fax
(864) 834-9701
NPI assigned
Feb 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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 PT.6633PT SC Primary

Addresses

Primary practice location

146 Walnut LN Ste a
Travelers Rest, SC 29690-1672

Mailing address

146 Walnut LN Ste a
Travelers Rest, SC 29690-1672
Phone (864) 834-0401

Other names 1

  • Jessica Hoffman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240201004022 SC Practitioner - Physical Therapist in Private Practice 6103279419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

104 Dillon Dr
Spartanburg, SC 29307-1018
Phone (864) 278-0233

1560 Thornblade Blvd
Greer, SC 29650-4448
Phone (864) 966-1723

190 River Park Dr
Little River, SC 29566-6844
Phone (843) 734-1457

2203 Marchbanks Ave
Anderson, SC 29621-2247
Phone (864) 437-8898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT.6633PTSCMDPhysical Therapist
6633SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients

Locations

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 2

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": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1033482575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 WALNUT LN STE A",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296901672",
            "telephone_number": "864-834-0401",
            "fax_number": "864-834-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 WALNUT LN STE A",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296901672",
            "telephone_number": "864-834-0401",
            "fax_number": "864-834-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBS",
        "first_name": "JESSICA",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "PT.6633PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HOFFMAN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Travelers Rest, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.