Individual provider Active NPI

Benjamin Allen Blanton, DPT

  • Physical Therapist
  • Simpsonville, SC
National Provider Identifier
1083400188
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2615 Woodruff Rd Ste 400
Simpsonville, SC 29681-6828
Phone
(864) 537-5016
Fax
(864) 302-8373
NPI assigned
Apr 16, 2025
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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 12812 NC
Physical Therapist 225100000X SC Primary

Addresses

Primary practice location

2615 Woodruff Rd Ste 400
Simpsonville, SC 29681-6828

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

2615 Woodruff Rd Ste 400
Simpsonville, SC 29681-6828
Phone (864) 537-5016

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250512001242 SC Practitioner - Physical Therapist in Private Practice 5395262497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 clinicians

Practice addresses (Care Compare)

2615 Woodruff Rd
Suite 400
Simpsonville, SC 29681-6828
Phone (864) 537-5016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12812NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince May 5, 2025 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince May 5, 2025 Accepting new patients

Locations

33205 Collection Ctr Dr
Chicago, IL 60693

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

200 Patewood Dr
Ste C150
Greenville, SC 29615
Phone (864) 454-0904

2615 Woodruff Rd
Ste 400
Simpsonville, SC 29681
Phone (864) 537-5016

32 Magnolia Cove Dr
#A
Simpsonville, SC 29680
Phone (864) 881-3745

727 SE Main St
Ste 200
Simpsonville, SC 29681
Phone (864) 454-6670

333 S Pine St
Spartanburg, SC 29302
Phone (864) 515-7500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1083400188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 WOODRUFF RD STE 400",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296816828",
            "telephone_number": "864-537-5016",
            "fax_number": "864-302-8373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 Woodruff Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Simpsonville",
            "state": "SC",
            "postal_code": "296816828",
            "country_code": "US",
            "telephone_number": "864-537-5016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANTON",
        "first_name": "BENJAMIN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "12812",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.