NPIMap

Organization Active NPI

Southern States Physical Medicine and Rehabiliation Center

Doing business as Southern States Family Health Center

  • Chiropractor
  • Fort Mill, SC
National Provider Identifier
1114943099
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2158 Issued in SC
Legal business name
SOUTHERN STATES PHYSICAL MEDICINE AND REHABILIATION CENTER
Doing business as
Southern States Family Health Center
Practice address
8763 Charlotte Hwy
Fort Mill, SC 29715-7589
Phone
(803) 548-8452
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Glenn GeadaNPI 1639129638
Title
Owner
Phone
(803) 283-8442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 2158 SC Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 3884 SC

Addresses

Primary practice location

8763 Charlotte Hwy
Fort Mill, SC 29715-7589

Mailing address

1002 N Woodland Dr
Lancaster, SC 29720-1966

Other names 1

  • Southern States Family Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern States Family Health Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1114943099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N WOODLAND DR",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297201966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8763 CHARLOTTE HWY",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157589",
            "telephone_number": "803-548-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN STATES PHYSICAL MEDICINE AND REHABILIATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GEADA",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-283-8442"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2158",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "3884",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern States Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.