Individual provider Active NPI

Andrea Marie Styron, MSR-PT

  • Physical Therapist
  • North Charleston, SC
National Provider Identifier
1124276076
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5385 Issued in SC
Practice address
4600 Goer Dr
North Charleston, SC 29406-6500
Phone
(843) 744-5527
Fax
(843) 746-9246
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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 5385 SC Primary

Addresses

Primary practice location

4600 Goer Dr
North Charleston, SC 29406-6500

Mailing address

4600 Goer Dr
North Charleston, SC 29406-6500
Phone (843) 744-5527

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090408000571 SC Practitioner - Physical Therapist in Private Practice 1355498353 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5385SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services of South Carolina, LLC Physical Therapist CurrentSince Nov 1, 2019 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 1

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1124276076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 GOER DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066500",
            "telephone_number": "843-744-5527",
            "fax_number": "843-746-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 GOER DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066500",
            "telephone_number": "843-744-5527",
            "fax_number": "843-746-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STYRON",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSR-PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.