Individual provider Active NPI

Walker Smith

  • Physical Therapist
  • Beaufort, SC
National Provider Identifier
1205336880
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9006 Issued in SC
Practice address
18 Professional Village Cir
Beaufort, SC 29907-1570
Phone
(843) 986-9670
Fax
(843) 986-9369
NPI assigned
Feb 20, 2018
Last updated
Feb 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9006 SC Primary

Addresses

Primary practice location

18 Professional Village Cir
Beaufort, SC 29907-1570

Mailing address

18 Professional Village Cir
Beaufort, SC 29907-1570
Phone (843) 986-9670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180504000397 SC Practitioner - Physical Therapist in Private Practice 2860756541 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gravity Physical Therapy IncGroup PAC ID 4789984832, 8 clinicians

Practice addresses (Care Compare)

2121 Boundary St
Suite 200
Beaufort, SC 29902-6812
Phone (843) 524-4778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9006SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gravity Physical Therapy, Inc. CurrentSince Nov 7, 2023 Accepting new patients
Elite Integrated Therapy Centers, LLC Physical Therapist CurrentSince May 31, 2022 Accepting new patients
Cora South Carolina LLC CurrentSince Jan 22, 2019 Accepting new patients
Cora South Carolina LLC CurrentSince Jan 22, 2019 Accepting new patients

Locations

2005 E Greenville St
Ste 119
Anderson, SC 29621
Phone (864) 512-7023

2121 Boundary St
Ste 200
Beaufort, SC 29902
Phone (843) 379-2320

18 Professional Village Cir
Beaufort, SC 29907
Phone (843) 521-9673

876 Fording Island Rd
Ste 2
Bluffton, SC 29910
Phone (843) 507-8473

1007 Grove Rd
#A
Greenville, SC 29605

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1205336880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PROFESSIONAL VILLAGE CIR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299071570",
            "telephone_number": "843-986-9670",
            "fax_number": "843-986-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PROFESSIONAL VILLAGE CIR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299071570",
            "telephone_number": "843-986-9670",
            "fax_number": "843-986-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WALKER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.