Active NPI
Jenifer Gayle Pearson
- Physical Therapist
- Columbia, SC
National Provider Identifier
1174112031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5254
- Practice address
- 3016 Longtown Commons Dr Ste 115
Columbia, SC 29229-7849 - Phone
- (803) 314-0529
- Fax
- (803) 314-0543
- NPI assigned
- Jan 14, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5254 | SC | Primary |
Addresses
Primary practice location
3016 Longtown Commons Dr Ste 115
Columbia, SC 29229-7849
Mailing address
33 Baldur CT
Columbia, SC 29229-6503
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1174112031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 BALDUR CT",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292296503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3016 LONGTOWN COMMONS DR STE 115",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292297849",
"telephone_number": "803-314-0529",
"fax_number": "803-314-0543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "JENIFER",
"middle_name": "GAYLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-14",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "5254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.