Individual provider Active NPI

Jan Speaks

  • Physical Therapist
  • Simpsonville, SC
National Provider Identifier
1215260583
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1916 Issued in SC
Practice address
719B SE Main St
Simpsonville, SC 29681-3237
Phone
(864) 963-9229
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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 1916 SC Primary

Addresses

Primary practice location

719B SE Main St
Simpsonville, SC 29681-3237

Mailing address

719B SE Main St
Simpsonville, SC 29681-3237

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100105000653 SC Practitioner - Physical Therapist in Private Practice 1850432410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Weston Group of South Carolina IncGroup PAC ID 2062651185, 80 clinicians

Practice addresses (Care Compare)

3709 Clark Rd
Boiling Springs, SC 29316-9787
Phone (864) 345-2701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1916SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Weston Group of South Carolina Inc Physical Therapist CurrentSince Nov 11, 2023 Accepting new patients
Sports Spine & Industrial, Inc. Physical Therapist PastSince Jun 3, 2002 Accepting new patients
The Weston Group, Inc. Physical Therapist Past Accepting new patients
Elite Integrated Therapy Centers, LLC Physical Therapist PastSince Nov 1, 2021 Accepting new patients

Locations

3709 Clark Rd
Boiling Springs, SC 29316
Phone (864) 345-2701

872 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-3050

3736 Robert M Grissom Pkwy
Myrtle Beach, SC 29577
Phone (843) 448-9300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1215260583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719B SE MAIN ST",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719B SE MAIN ST",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813237",
            "telephone_number": "864-963-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEAKS",
        "first_name": "JAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "1916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.