Supplemental Healthcare

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1931 Issued in SC

Legal business name

SUPPLEMENTAL HEALTHCARE

Practice address

6033 Brookgreen CT
Spartanburg, SC 29301-3547

Phone

(864) 764-5189

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Adger Ryan Moore Jr., P.T.A.

Title

Physical Therapist Assistant

Phone

(864) 764-5189

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1144409640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 BROOKGREEN CT",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293013547",
            "telephone_number": "864-764-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 BROOKGREEN CT",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293013547",
            "telephone_number": "864-764-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPLEMENTAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ADGER",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST ASSISTANT",
        "authorized_official_telephone_number": "864-764-5189",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "P.T.A."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "1931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Hills, LLC
• Summit Hills, LLC
• Amanda Friday Sun, MMFT, LMFT
• Superior Health and Wellness Spartanburg
• Superior Healthcare of Spartanburg
• Elizabeth R Surgeon, MA
• Aqil Ebun Surka, MD
• Gayatri Sarangdhar Surwade, M.D
• Susan C. Smart, LM, CPM
• Susan Lea, LLC

• Home Health Agency in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Home Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.