Individual provider Active NPI

Gavin Stepansky

  • Physical Therapist
  • Myrtle Beach, SC
National Provider Identifier
1033999792
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4871 Socastee Blvd Unit E
Myrtle Beach, SC 29588-7252
Phone
(843) 293-5610
NPI assigned
Oct 2, 2023
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 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 NU Primary

Addresses

Primary practice location

4871 Socastee Blvd Unit E
Myrtle Beach, SC 29588-7252

Mailing address

1993 Mossy Point CV
Myrtle Beach, SC 29579-7597

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora Health Services, Inc. Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients
Cora South Carolina LLC Past Accepting new patients

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1033999792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1993 MOSSY POINT CV",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295797597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4871 SOCASTEE BLVD UNIT E",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887252",
            "telephone_number": "843-293-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANSKY",
        "first_name": "GAVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.