Individual provider Active NPI

Skylar Tucker, DPT

  • Physical Therapist
  • Myrtle Beach, SC
National Provider Identifier
1184506396
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP048746T Issued in SC
Practice address
210 Village Center Blvd Ste 100
Myrtle Beach, SC 29579-6706
Phone
(843) 353-3460
NPI assigned
Jul 21, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05016161A IN
Physical Therapist 225100000X CP048746T SC Primary

Addresses

Primary practice location

210 Village Center Blvd Ste 100
Myrtle Beach, SC 29579-6706

Mailing address

889 N 1375 W
Linton, IN 47441-6513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251002000181 SC Practitioner - Physical Therapist in Private Practice 8426554072 Reassigns benefits to 1 organization
I20260410002777 WA Practitioner - Physical Therapist in Private Practice 8426554072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthosc LLCGroup PAC ID 8022370030, 113 clinicians
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

210 Village Ctr Blvd
Suite 100
Myrtle Beach, SC 29579-6706
Phone (843) 491-4937

8011 112TH St CT E
Puyallup, WA 98373-7814
Phone (253) 848-0662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05016161AINMDPhysical Therapist
CP048746TSCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosc, LLC CurrentSince Aug 25, 2025 Accepting new patients
Orthosc, LLC CurrentSince Aug 25, 2025 Accepting new patients
Orthosc, LLC PastSince May 29, 2022 Accepting new patients

Locations

2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222

210 Village Center Blvd
Ste 200
Myrtle Beach, SC 29579
Phone (843) 236-3222

210 Village Center Blvd
Ste 100
Myrtle Beach, SC 29579
Phone (843) 491-4937

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4
  • Direct secure messaging: skylar.tucker.1@17161.direct.athenahealth.com

Organizations & group practices 4

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": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1184506396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 N 1375 W",
            "city": "LINTON",
            "state": "IN",
            "postal_code": "474416513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD STE 100",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-353-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "SKYLAR",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05016161A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "CP048746T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.