NPIMap

Organization Active NPI

Your Life Wellness and Physical Therapy

  • Physical Therapy Clinic/Center
  • Indian Land, SC
National Provider Identifier
1184973489
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2342 Issued in SC
Legal business name
YOUR LIFE WELLNESS AND PHYSICAL THERAPY
Practice address
7580 Charlotte Hwy
Suite 500
Indian Land, SC 29707-7801
Phone
(803) 548-5662
Fax
(803) 548-5635
NPI assigned
Aug 31, 2012
Last updated
Aug 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Authorized official

Name
Mrs. Lee Ann Gaston, P. TLNPI 1346599867
Title
Owner/Physical Therapist
Phone
(803) 548-5662

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2342 SC Primary

Addresses

Primary practice location

7580 Charlotte Hwy
Suite 500
Indian Land, SC 29707-7801

Mailing address

7580 Charlotte Hwy
Suite 500
Indian Land, SC 29707-7801
Phone (803) 548-5662

National Provider Directory

National Provider Directory

Locations

7580 Charlotte Hwy
Ste 1100
Indian Land, SC 29707
Phone (803) 548-5662

7580 Charlotte Hwy
Ste 500
Indian Land, SC 29707
Phone (803) 548-5662

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346371200000",
    "number": "1184973489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 CHARLOTTE HWY",
            "address_2": "SUITE 500",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077801",
            "telephone_number": "803-548-5662",
            "fax_number": "803-548-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 CHARLOTTE HWY",
            "address_2": "SUITE 500",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077801",
            "telephone_number": "803-548-5662",
            "fax_number": "803-548-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR LIFE WELLNESS AND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-31",
        "last_updated": "2012-08-31",
        "status": "A",
        "authorized_official_last_name": "GASTON",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "803-548-5662",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P. TL"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "SC",
            "license": "2342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Land, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.