Lava Physical Therapy at Medical Pavilion

Primary specialty

SpecialistTaxonomy code 174400000X

License

4351 Issued in SC

Legal business name

LAVA PHYSICAL THERAPY AT MEDICAL PAVILION

Doing business as

Lava Physical Therapy

Practice address

25 Hospital Center Blvd Ste 106
Hilton Head Island, SC 29926-2735

Phone

(843) 689-5282

Fax

(843) 689-5280

NPI assigned

Feb 10, 2016

Last updated

Feb 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathan Dixon

Title

Owner

Phone

(843) 338-0520

Specialties & licenses 1

Addresses

Other names 1

• LAVA PHYSICAL THERAPY Doing business as

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1063870681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HOSPITAL CENTER BLVD STE 106",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262735",
            "telephone_number": "843-689-5282",
            "fax_number": "843-689-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HOSPITAL CENTER BLVD STE 106",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262735",
            "telephone_number": "843-689-5282",
            "fax_number": "843-689-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVA PHYSICAL THERAPY AT MEDICAL PAVILION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-338-0520"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "4351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAVA PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Randy M. Kurjan, M.S., CCC-SLP
• La Clinica
• Randy Raissa Lagoc-Dingus, MD
• Gary L Lattimer, MD
• Robert Abel Laughlin, M.D.
• Stephanie Lawrence, OTR
• Tami Lawrence, M.S.,OTR/L
• Kelley M. Leblanc, D.C.
• Flavien Eric Leclere
• Sang Wha Lee, MD

• Specialist in Hilton Head Island, SC
• Providers in Hilton Head Island, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.