Individual provider Active NPI

Alexis W Lockyer, PT

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1093720906
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4446 Issued in SC
Practice address
103 N Main St
Ste 300
Greenville, SC 29601-2796
Phone
(864) 528-5753
NPI assigned
Jul 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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 4446 SC Primary
Physical Therapist 225100000X 9925 TN

Addresses

Primary practice location

103 N Main St
Ste 300
Greenville, SC 29601-2796

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers 5

IdentifierTypeStateIssuer
650026189OtherSCMEDICARE RAILROAD NUMBER
C5655OtherSCMEDCOST NUMBER
943423122OtherSCPROVIDER NUMBER
7796338OtherSCAETNA
354105600OtherSCDEPT. OF LABOR NUMBER

Other names 1

  • Alexis Michelle Whitaker Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151005002937 SC Practitioner - Physical Therapist in Private Practice 7214150168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 Grove Rd
Greenville, SC 29605-4649
Phone (864) 234-7654

180 Halton Rd
Greenville, SC 29607-3508
Phone (864) 220-4263

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

35 International Dr
Greenville, SC 29615-4816
Phone (864) 513-1136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4446SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Aug 24, 2015 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Aug 24, 2015 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Sports Spine & Industrial, Inc. Physical Therapist PastSince Jun 3, 2002 Accepting new patients
St Francis Physician Services Inc Past Accepting new patients
Elite Integrated Therapy Centers, LLC Physical Therapist PastSince Nov 1, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

103 N Main St
Ste 300
Greenville, SC 29601

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

1050 Grove Rd
Greenville, SC 29605
Phone (864) 242-5020

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

35 International Dr
Greenville, SC 29615
Phone (864) 242-5020

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1093720906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N MAIN ST",
            "address_2": "STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012796",
            "telephone_number": "864-528-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKYER",
        "first_name": "ALEXIS",
        "middle_name": "W",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4446",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "9925",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD NUMBER",
            "identifier": "650026189",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST NUMBER",
            "identifier": "C5655",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "943423122",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7796338",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR NUMBER",
            "identifier": "354105600",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "WHITAKER",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Nov 9, 2015; 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.