Active NPI
Antonia Pitalo, P.T.
- Physical Therapist
- Greenville, SC
National Provider Identifier
1073546115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5177
- Practice address
- 209 Patewood Dr
Suite 100
Greenville, SC 29615-3581 - Phone
- (864) 272-0124
- Fax
- (864) 272-0129
- NPI assigned
- Jul 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5177 | SC | Primary |
Addresses
Primary practice location
209 Patewood Dr
Suite 100
Greenville, SC 29615-3581
Mailing address
1361 W Wade Hampton Blvd Ste F
PMB 207
Greer, SC 29650-1146
Phone (864) 801-8706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 452518585 | Other | SC | INSURANCE PROVIDER NUMBER |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports Spine & Industrial, Inc. | Physical Therapist | Past | Accepting new patients |
| Elite Integrated Therapy Centers, LLC | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Greenville, SC
- NPI 1184673600
-
- Physical Therapist
- Greer, SC
- NPI 1093748121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1073546115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1361 W WADE HAMPTON BLVD STE F",
"address_2": "PMB 207",
"city": "GREER",
"state": "SC",
"postal_code": "296501146",
"telephone_number": "864-801-8706",
"fax_number": "864-848-7203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 PATEWOOD DR",
"address_2": "SUITE 100",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153581",
"telephone_number": "864-272-0124",
"fax_number": "864-272-0129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITALO",
"first_name": "ANTONIA",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-09",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "5177",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE PROVIDER NUMBER",
"identifier": "452518585",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.