Individual provider Active NPI

Branton Rice Queen, PT

  • Physical Therapist
  • Myrtle Beach, SC
National Provider Identifier
1104859610
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3695 Issued in SC
Practice address
210 Village Center Blvd Ste 100
Myrtle Beach, SC 29579-6706
Phone
(843) 353-3460
Fax
(843) 353-3461
NPI assigned
Jul 8, 2006
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3695 SC Primary

Addresses

Primary practice location

210 Village Center Blvd Ste 100
Myrtle Beach, SC 29579-6706

Mailing address

210 Village Center Blvd Ste 140
Myrtle Beach, SC 29579-6706
Phone (843) 353-3460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220503001067 SC Practitioner - Physical Therapist in Private Practice 6406871292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthosc LLCGroup PAC ID 8022370030, 113 clinicians

Practice addresses (Care Compare)

3620 Walton Dr
Unit C5 and C6
Myrtle Beach, SC 29577-6781
Phone (843) 353-3460

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosc, LLC CurrentSince Apr 27, 2022 Accepting new patients
Orthosc, LLC CurrentSince Apr 27, 2022 Accepting new patients
Orthosc, LLC PastSince May 29, 2022 Accepting new patients

Locations

2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222

210 Village Center Blvd
Ste 100
Myrtle Beach, SC 29579
Phone (843) 491-4937

210 Village Center Blvd
Ste 140
Myrtle Beach, SC 29579
Phone (843) 333-8385

3620 Walton Dr
Unit C5
Myrtle Beach, SC 29577

3620 Walton Dr
Unit C56
Myrtle Beach, SC 29577

Interoperability endpoints

  • Direct secure messaging: branton.queen.1@17161.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1104859610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD STE 140",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-353-3460",
            "fax_number": "843-353-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD STE 100",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-353-3460",
            "fax_number": "843-353-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "BRANTON",
        "middle_name": "RICE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "3695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.