NPIMap

Organization Active NPI

Cora South Carolina LLC

Doing business as CORA Physical Therapy - Bluffton

  • Physical Therapy Clinic/Center
  • Bluffton, SC
National Provider Identifier
1164923355
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CORA SOUTH CAROLINA LLC
Doing business as
CORA Physical Therapy - Bluffton
Practice address
876 Fording Island Rd Ste 2
Bluffton, SC 29910-8677
Phone
(419) 221-6720
Fax
(419) 222-0507
NPI assigned
Feb 23, 2018
Last updated
Oct 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Authorized official

Name
Stephen Krzyminski
Title
Executive Vice President
Phone
(419) 221-6717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

876 Fording Island Rd Ste 2
Bluffton, SC 29910-8677

Mailing address

PO Box 150
Lima, OH 45802-0150
Phone (419) 221-6717

Other names 1

  • CORA Physical Therapy - Bluffton Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180326002748 SC Part B Supplier - Clinic/Group Practice 3173766334 Receives reassigned benefits from 23 practitioners
7 other NPIs on this enrollment
Practice locations: Beaufort, SC; Bluffton, SC; Florence, SC; Fort Mill, SC; Johns Island, SC; Rock Hill, SC
O20181001003128 SC Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3173766334 4 other NPIs on this enrollment
Practice locations: Beaufort, SC; Hilton Head Island, SC; Bluffton, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164923355. Details of each certification follow.

  • CCN 426654 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 426654

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CORA PHYSICAL THERAPY - BLUFFTON
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Feb 11, 2019
Last certification
Feb 11, 2019
Ownership / control type
Proprietary
Facility address
876 Fording Island Road
Bluffton, SC 29910

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cora South Carolina LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

876 Fording Island Rd
Ste 2
Bluffton, SC 29910
Phone (843) 507-8473

2199 N Fraser St
Georgetown, SC 29440
Phone (843) 527-0225

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1164923355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458020150",
            "telephone_number": "419-221-6717",
            "fax_number": "419-222-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 FORDING ISLAND RD STE 2",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299108677",
            "telephone_number": "419-221-6720",
            "fax_number": "419-222-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORA SOUTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-23",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "KRZYMINSKI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "419-221-6717"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - Bluffton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.