Kaylee Addison, PT, DPT
Individual provider Active NPI Physical Therapist · Anderson, SC
NPI 1194128280 · NPPES record last updated Oct 2, 2014
Key facts
- NPI
- 1194128280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 7379 (SC)
- Practice address
- 1501 E Greenville St
Anderson, SC 29621-2004 - Phone
- (864) 226-8356
- Fax
- (864) 622-2625
- NPI assigned
- Oct 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7379 | SC | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7379 | SC | Yes |
Addresses
Primary practice location
1501 E Greenville St
Anderson, SC 29621-2004
Mailing address
1501 E Greenville St
Anderson, SC 29621-2004
Phone (864) 226-8356
NPI Registry JSON
{
"created_epoch": "1412208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412208000000",
"number": "1194128280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 E GREENVILLE ST",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296212004",
"telephone_number": "864-226-8356",
"fax_number": "864-622-2625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 E GREENVILLE ST",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296212004",
"telephone_number": "864-226-8356",
"fax_number": "864-622-2625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADDISON",
"first_name": "KAYLEE",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-02",
"last_updated": "2014-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "7379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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All providers in Anderson, SC · Physical Therapist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.