Individual provider Active NPI

Maria Alanna Gene Phillips, PT

  • Physical Therapist
  • Florence, SC
National Provider Identifier
1164159273
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10108 Issued in SC
Practice address
610 W Palmetto St
Florence, SC 29501-4302
Phone
(843) 407-0377
Fax
(843) 799-1944
NPI assigned
Aug 8, 2022
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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 10108 SC Primary

Addresses

Primary practice location

610 W Palmetto St
Florence, SC 29501-4302

Mailing address

PO Box 6526
Columbia, SC 29260-6526
Phone (803) 693-5040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230412001000 SC Practitioner - Physical Therapist in Private Practice 6800261538 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pro-Motion Physical Therapy of Florence, SC, LLC Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Ih3 Physcial Therapy Physical Therapist PastSince Aug 14, 2022 Accepting new patients

Locations

610 W Palmetto St
Florence, SC 29501
Phone (843) 374-0185

148 Sauls St
Ste B
Lake City, SC 29560
Phone (843) 374-0185

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": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1164159273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6526",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292606526",
            "telephone_number": "803-693-5040",
            "fax_number": "803-993-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W PALMETTO ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014302",
            "telephone_number": "843-407-0377",
            "fax_number": "843-799-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARIA ALANNA",
        "middle_name": "GENE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.