Individual provider Active NPI

Derek L. White, RPT

  • Physical Therapist
  • Mount Pleasant, SC
National Provider Identifier
1164525630
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4252 Issued in SC
Practice address
1602 N Highway 17
Mount Pleasant, SC 29464-3310
Phone
(843) 800-0773
Fax
(843) 800-0837
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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 4252 SC Primary

Addresses

Primary practice location

1602 N Highway 17
Mount Pleasant, SC 29464-3310

Mailing address

800 Crescent Centre Dr Ste 300
Franklin, TN 37067-7285
Phone (615) 373-1350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151021003052 SC Practitioner - Physical Therapist in Private Practice 1850600446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

1146 Muhlenbergia Dr
Suite 101
Mt Pleasant, SC 29466-8406
Phone (843) 998-7302

3032 W Montague Ave
Suite 101
North Charleston, SC 29418-7921
Phone (843) 885-8772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince Aug 24, 2015 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Aug 24, 2015 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1812 Sam Rittenberg Blvd
Ste 18
Charleston, SC 29407
Phone (843) 779-7377

1602 N Highway 17
Mt Pleasant, SC 29464
Phone (843) 800-0773

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

800 Crescent Centre Dr
Ste 300
Franklin, TN 37067

800 Crescent Centre Dr
Ste 600
Franklin, TN 37067
Phone (615) 416-0199

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1164525630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677285",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 N HIGHWAY 17",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643310",
            "telephone_number": "843-800-0773",
            "fax_number": "843-800-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "DEREK",
        "middle_name": "L.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.