Active NPI
Jaclyn Mabalot
- Physical Therapist
- West Columbia, SC
National Provider Identifier
1194548909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 2416 Sunset Blvd
West Columbia, SC 29169-4718 - Phone
- (803) 796-8024
- NPI assigned
- Nov 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
2416 Sunset Blvd
West Columbia, SC 29169-4718
Mailing address
205 Lockwood Dr
Lexington, SC 29072-3938
Other practice location 1
100 Finley Rd
Columbia, SC 29203-9264
Phone (803) 691-5720
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730419200000",
"number": "1194548909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 LOCKWOOD DR",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290723938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2416 SUNSET BLVD",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291694718",
"telephone_number": "803-796-8024"
}
],
"practiceLocations": [
{
"address_1": "100 Finley Rd",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292039264",
"country_code": "US",
"telephone_number": "803-691-5720",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MABALOT",
"first_name": "JACLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-01",
"last_updated": "2024-11-01",
"certification_date": "2024-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.