Individual provider Active NPI

Shannon Raenell Lloyd, MSPT

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1124327390
Registry record updated Mar 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5833 Issued in SC
Practice address
731 Polo Rd
Columbia, SC 29223-4462
Phone
(803) 419-0431
Fax
(803) 419-0338
NPI assigned
Mar 27, 2011
Last updated
Mar 27, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2011

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 5833 SC Primary

Addresses

Primary practice location

731 Polo Rd
Columbia, SC 29223-4462

Mailing address

731 Polo Rd
Columbia, SC 29223-4462
Phone (803) 419-0431

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251104004294 SC Practitioner - Physical Therapist in Private Practice 5799005039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

125 Emeryville Dr
Suite 320
Cranberry Township, PA 16066-5023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5833SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients

Locations

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

1925 Essex Farms Dr
Charleston, SC 29414
Phone (843) 779-1685

5130 Westcott Blvd
Summerville, SC 29485
Phone (843) 486-2712

Organizations & group practices 2

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": "1301184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301184000000",
    "number": "1124327390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 POLO RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234462",
            "telephone_number": "803-419-0431",
            "fax_number": "803-419-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 POLO RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234462",
            "telephone_number": "803-419-0431",
            "fax_number": "803-419-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLOYD",
        "first_name": "SHANNON",
        "middle_name": "RAENELL",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-27",
        "last_updated": "2011-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2011; 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.