Active NPI
Angela Stout Threeths
- Physical Therapist
- Greenville, SC
National Provider Identifier
1164965430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8545
- Practice address
- 35 International Dr
Greenville, SC 29615-4816 - Phone
- (864) 234-7654
- NPI assigned
- Nov 18, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | T012547 | GA | |
| Physical Therapist | 225100000X | 09487R | LA | |
| Physical Therapist | 225100000X | 8545 | SC | Primary |
Addresses
Primary practice location
35 International Dr
Greenville, SC 29615-4816
Mailing address
PO Box 631341
Cincinnati, OH 45263-1341
Other names 1
- Angela Stout
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8545 | SC | MD | Professional Counselor |
| T012547 | GA | MD | Physical Therapist |
| 09487R | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679529600000",
"number": "1164965430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 631341",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452631341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 INTERNATIONAL DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154816",
"telephone_number": "864-234-7654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THREETHS",
"first_name": "ANGELA",
"middle_name": "STOUT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-18",
"last_updated": "2023-03-23",
"certification_date": "2023-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "T012547",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "09487R",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "8545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "STOUT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Greenville, SC
- Dylan Louise Thorp, SLP
- Thomas Eric Thorsheim, PHD
- Wanda Threadgill, O.D.
- Three Springs Dialectical Behavior Therapy Group, LLC
- Three Springs Dialectical Behavior Therapy of the Upstate, LLC
- Jahan Threeths
- Jason Richard Thrift, PHD, RN, CHSE, NI-BC
- Shonda Michelle Thrift, PA
- Thrive Behavioral Consultants LLC
- Thrive Family Medicine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.