Active NPI
Stephen Bendziewicz, DPT, PT
- Pediatric Physical Therapist
- Irmo, SC
National Provider Identifier
1114559192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT.10101
- Practice address
- 206 Blackstone Dr
Irmo, SC 29063-7838 - Phone
- (803) 767-6361
- NPI assigned
- Feb 7, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT.10101 | SC | Primary |
Addresses
Primary practice location
206 Blackstone Dr
Irmo, SC 29063-7838
Mailing address
206 Blackstone Dr
Irmo, SC 29063-7838
Phone (803) 767-6361
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT.10101 | SC | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581033600000",
"number": "1114559192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 BLACKSTONE DR",
"city": "IRMO",
"state": "SC",
"postal_code": "290637838",
"telephone_number": "803-767-6361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 BLACKSTONE DR",
"city": "IRMO",
"state": "SC",
"postal_code": "290637838",
"telephone_number": "803-767-6361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENDZIEWICZ",
"first_name": "STEPHEN",
"credential": "DPT, PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-07",
"last_updated": "2020-02-07",
"certification_date": "2020-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "SC",
"license": "PT.10101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irmo, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.