Jessica Ann Mentrup, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8884 Issued in SC

Practice address

399 Silver Bluff Rd Ste B
Aiken, SC 29803-6007

Phone

(803) 644-4264

Fax

(803) 226-0123

NPI assigned

Jan 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehabilitation Services of South Carolina, LLCGroup PAC ID 3971639998, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Rehabilitation Services of South Carolina, LLC

  • Physical Therapist
  • Lexington, SC
  • NPI 1902133689
  Medicare reassignment Care Compare group
• Greenville Proaxis Therapy, LLC

  • Physical Therapist
  • Greenville, SC
  • NPI 1669457859
  Medicare reassignment NPD
• Greenville Proaxis Therapy LLC

  • Durable Medical Equipment & Medical Supplies
  • Greenville, SC
  • NPI 1740052000
  NPD

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104333897",
    "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": "630-296-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 SILVER BLUFF RD STE B",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298036007",
            "telephone_number": "803-644-4264",
            "fax_number": "803-226-0123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 E Greenville St Ste G",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296212056",
            "country_code": "US",
            "telephone_number": "864-261-3099",
            "fax_number": "864-261-6617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "184 University Pkwy",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "298016308",
            "country_code": "US",
            "telephone_number": "803-649-9975",
            "fax_number": "803-649-3357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENTRUP",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary-Kathryn Carroll Medlen, DPT
• Christina Meeks, ED.S., NCSP
• Mark J Meiler, MD
• Kelly Melody
• Jorge Felipe Mena Acevedo, MD
• Jaya Bindu Merugu, MD
• Isabelle Messer, LPN
• Theodore Mark Meyer, M.D.
• Mi'Angels Caretakers LLC
• Michael D. Fulford, PA

• Physical Therapist in Aiken, SC
• Providers in Aiken, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.