Individual provider Active NPI

Jamaeca Tenee Roberts

  • Physical Therapist
  • Fort Mill, SC
National Provider Identifier
1063392140
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13059 Issued in SC
Practice address
1698 Highway 160 W Ste 240
Fort Mill, SC 29708-8035
Phone
(704) 654-8599
Fax
(980) 938-6088
NPI assigned
Sep 8, 2025
Last updated
Feb 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P24305 NC
Physical Therapist 225100000X 13059 SC Primary

Addresses

Primary practice location

1698 Highway 160 W Ste 240
Fort Mill, SC 29708-8035

Mailing address

1698 Highway 160 W Ste 240
Fort Mill, SC 29708-8035
Phone (704) 654-8599

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

State licenses

LicenseStateTypeSpecialty
P24305NCMDPhysical Therapist
13059SCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1063392140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 HIGHWAY 160 W STE 240",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088035",
            "telephone_number": "704-654-8599",
            "fax_number": "980-938-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 HIGHWAY 160 W STE 240",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088035",
            "telephone_number": "704-654-8599",
            "fax_number": "980-938-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JAMAECA",
        "middle_name": "TENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24305",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "13059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.