Summerville Physical Therapy & Balance Rehabilitation for Adults, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4850 Issued in SC

Legal business name

SUMMERVILLE PHYSICAL THERAPY & BALANCE REHABILITATION FOR ADULTS, LLC

Practice address

679 Orangeburg Road
Suite D
Summerville, SC 29483

Phone

(843) 209-6375

Fax

(843) 225-0348

NPI assigned

Mar 17, 2016

Last updated

Jan 25, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David P Brungo, P.T.NPI 1275654204

Title

Owner/Member/Physical Therapist

Phone

(843) 209-6375

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 2

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.

• David Paul Brungo, PT, MBA, MS, AIB-CVR

  • Physical Therapist
  • Summerville, SC
  • NPI 1275654204
  Medicare reassignment Care Compare group NPD Authorized official
• Ryan Matthew Carpenter, DPT

  • Physical Therapist
  • Summerville, SC
  • NPI 1700421054
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548374400000",
    "number": "1194186213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 ORANGEBURG ROAD",
            "address_2": "SUITE D",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29483",
            "telephone_number": "843-209-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 ORANGEBURG ROAD",
            "address_2": "SUITE D",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29483",
            "telephone_number": "843-209-6375",
            "fax_number": "843-225-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE PHYSICAL THERAPY & BALANCE REHABILITATION FOR ADULTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2019-01-25",
        "status": "A",
        "authorized_official_last_name": "BRUNGO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/MEMBER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "843-209-6375",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summerville Internal Medicine
• Summerville Pediatric Dentistry
• Summerville Pediatric Eyecare
• Summerville Pediatric Eyecare PC
• Summerville Pediatric Occupational Therapy, LLC
• Summerville Primary Care
• Summerville Primary Eyecare LLC (Summerville Primary Eyecare)
• Summerville Sleep Consultants LLC
• Summerville Smiles Dental Office, PC
• Summerville Surgical Associates, PA

• Physical Therapist in Summerville, SC
• Providers in Summerville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.