Individual provider Active NPI

Anne Barnwell Jenkins, PT, DPT

  • Pediatric Physical Therapist
  • Charleston, SC
National Provider Identifier
1184402554
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
11882 Issued in SC
Practice address
142 Sportsman Island Dr Ste E
Charleston, SC 29492-8524
Phone
(843) 696-2174
NPI assigned
Sep 18, 2023
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 11882 SC Primary

Addresses

Primary practice location

142 Sportsman Island Dr Ste E
Charleston, SC 29492-8524

Mailing address

2 Ipswich CT Unit a
Charleston, SC 29403-7002
Phone (803) 429-0083

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11882SCMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holy City Pediatric Therapy LLC Pediatrics CurrentSince Sep 24, 2023 Accepting new patients

Locations

142 Sportsman Island Dr
Ste E
Daniel Island, SC 29492
Phone (843) 696-2174

Organizations & group practices 1

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1184402554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 IPSWICH CT UNIT A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294037002",
            "telephone_number": "803-429-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 SPORTSMAN ISLAND DR STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294928524",
            "telephone_number": "843-696-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "ANNE",
        "middle_name": "BARNWELL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "SC",
            "license": "11882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.

Verify at the official NPI Registry.