NPIMap

Organization Active NPI

Indigo Therapy Specialists, LLC

  • Physical Therapist
  • Murrells Inlet, SC
National Provider Identifier
1194960872
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5347 Issued in SC
Legal business name
INDIGO THERAPY SPECIALISTS, LLC
Practice address
11931 Plaza Dr
Murrells Inlet, SC 29576-9356
Phone
(843) 357-4039
Fax
(843) 357-4227
NPI assigned
Dec 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Authorized official

Name
Mr. Edgar J Klixbull, DPT, CSCSNPI 1114027778
Title
Owner/Director of Physical Therapy
Phone
(843) 357-4039

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 5347 SC Primary

Addresses

Primary practice location

11931 Plaza Dr
Murrells Inlet, SC 29576-9356

Mailing address

PO Box 1795
Murrells Inlet, SC 29576-1795
Phone (843) 357-4039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Outpatient physical therapy / speech pathology certification: CCN 426641

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
INDIGO THERAPY SPECIALISTS-MURRELL'S INLET
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Dec 16, 2014
Last certification
Feb 2, 2022
Ownership / control type
Proprietary
Facility address
11931 Plaza Drive
Murrells Inlet, SC 29576

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1194960872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1795",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295761795",
            "telephone_number": "843-357-4039",
            "fax_number": "843-357-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11931 PLAZA DR",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769356",
            "telephone_number": "843-357-4039",
            "fax_number": "843-357-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO THERAPY SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-09",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "KLIXBULL",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/DIRECTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "843-357-4039",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

Verify at the official NPI Registry.